Colorectal cancer usually develops from precancerous, abnormal growths in the colon or rectum. Screening tests can find these abnormal growths so they can be removed before they turn into cancer.
Disclaimer: Clinical preventive referral requirements
Cologuard™ referral is no longer required for TRICARE Prime beneficiaries
Exact Science has now joined the Humana Military network. If your physician provides you with Cologuard™, a referral is no longer required prior to testing, effective 6/1/22.
Find out more about colorectal cancer screenings and other covered clinical preventive services
Are colorectal cancer screenings covered?
TRICARE covers the following based on your risk factor.
Average risk:
- Starting screening at age 45
- Fecal Occult Blood Test (FOBT) once every (12 months) (includes: guaiac (gFOBT) and Fecal Immunochemical Test (FIT))
- Flexible sigmoidoscopy every five years (60 months)
- CT colonography every five years (60 months)
- FIT-DNA test every one to three years (12 to 36 months)
- Colonoscopy every ten years (120 months)
Increased risk:
- One or more first degree relatives diagnosed with sporadic colorectal cancer or an adenomatous polyp before the age of 60 or in two or more first degree relatives at any age.
What's covered: Optical colonoscopy every three to five years. This begins at age 40 or 10 years earlier than the youngest affected relative, whichever is earlier.
- One or more first degree relatives diagnosed with sporadic colorectal cancer or an adenomatous polyp at age 60 or older, or two second-degree relatives diagnosed with colon cancer.
What's covered: Flexible sigmoidoscopy (once every five years) or optical colonoscopy (once every 10 years). This begins at age 40 or 10 years earlier than the youngest affected relative, whichever is earlier.
High risk:
- Known or suspected Familial Adenomatous Polyposis (FAP).
What's covered: Flexible sigmoidoscopy annually beginning at age 10 to 12.
- Family history of Hereditary Non-Polyposis Colorectal Cancer (HNPCC) syndrome.
What's covered: Optical colonoscopy once every one to two years. This begins at age 20 to 25, or 10 years younger than the earliest age of diagnosis of colorectal cancer, whichever is earlier.
- Inflammatory Bowel Disease (IBD), Chronic Ulcerative Colitis (CUC), or Crohn's disease.
What's covered: Your cancer risk begins to be significant eight years after the onset of pancolitis or 10 to 12 years after the onset of left-sided colitis. If you have these risk factors, then you should get an optical colonoscopy every one to two years with biopsies for dysplasia.
This list of covered services is not all inclusive. TRICARE covers services that are medically necessary and considered proven. There are special rules or limits on certain services and some services are excluded.
What are some of the signs and symptoms?
- Blood in or on your stool
- Stomach pain, aches, or cramps that do not go away
- Unexplained weight loss
- A change in bowel habits
Am I at risk?
More than 90% of colorectal cancer occurs in people who are 50 years old or older. Other risk factors include:
- Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
- Personal or family history of colorectal cancer or colorectal polyps
- Lack of regular physical activity
- A diet low in fruits and vegetables
- Low-fiber and high-fat diet
- Being overweight or obese
- Alcohol consumption
- Tobacco use