Welcome to the Cleveland Clinic Colon Cancer Risk Assessment. By taking this colorectal cancer risk assessment, you are taking the first step in knowing how you can score against colon cancer!

Colon cancer usually develops from benign, precancerous growths or polyps in the colon called adenomas. Colon cancer screening tests such as colonoscopy detect and remove polyps before they turn into cancer, or can detect cancer in its curable stages making screening so important.

This risk assessment will take less than 5 minutes. You will be asked questions about your lifestyle, personal and family history of adenomatous polyps and colon cancer. The more information you provide about your personal and family history of colon polyps and cancer the better we can determine your risk.

After completing the assessment, you will receive your colon cancer risk score and personalized colon screening recommendations to know what to do next.

We recommend you discuss these findings and screening recommendations with your family physician.

To estimate your colorectal cancer risk, answer the following questions

Questions about yourself
Is your age less than 50 years?	Please select No Yes
What is your gender?	Please select Male Female
What is your ethnicity?	Please select White African American Asian American/Pacific Islander Hispanic/Latino Other
What is your weight?	pounds
What is your height?	Select 1 2 3 4 5 6 7 8 feet Select 0 1 2 3 4 5 6 7 8 9 10 11 inches
Have you ever had colorectal cancer screening?	Please select No Yes
Which screening test have you had? (select all that apply):
Colonoscopy within the past 10 years	Select Yes No
Stool test for blood within the last year	Select Yes No
Flexible sigmoidoscopy within the last 5 years	Select Yes No
How many servings of fruits and vegetables (not including potatoes and iceberg lettuce) do you eat each day?	Please select < 3 3 - 5 > 5
Are you a current smoker?	Please select No Yes
How many packs each day?	Please select < 1 1 - 2 > 2
How many years have you smoked?	Please select < 5 5 - 10 > 10
Did you smoke in the past?	Please select No Yes
How many packs each day?	Please select < 1 1 - 2 > 2
How many years did you smoke?	Please select < 5 5 - 10 > 10
How many years ago did you quit smoking?	Please select < 10 >= 10
Do you exercise at least 30 minutes 3-4 days a week?	Please select No Yes
Have you ever been diagnosed with colorectal cancer?	Please select No Yes
What was your age when diagnosed?	Please select Under age 50 Age 50 to less than age 60 Age 60 or older
Have you ever been diagnosed with colorectal adenomatous polyps?	Please select Yes No Don't know
Were you under the age of 60 when diagnosed?	Please select Yes No Don't know
Questions about your first degree relatives, such as your mother, father, children, sisters and brothers
Has your mother ever been diagnosed with colorectal cancer?	Please select Yes No Don't know
What age was your mother when she was diagnosed?	Please select Under age 50 Age 50 to less than age 60 Age 60 or older
Has your mother ever been diagnosed with colorectal adenomatous polyps?	Please select Yes No Don't know
Was your mother under the age of 60 when diagnosed?	Please select Yes No Don't know
Has your father ever been diagnosed with colorectal cancer?	Please select Yes No Don't know
What age was your father when he was diagnosed?	Please select Under age 50 Age 50 to less than age 60 Age 60 or older
Has your father ever been diagnosed with colorectal adenomatous polyps?	Please select Yes No Don't know
Was your father under the age of 60 when diagnosed?	Please select Yes No Don't know
Have any of your children been diagnosed with colorectal cancer?	Please select Yes No Don't know
Please select the number of your children when diagnosed under each age range:
Under age 50 Select 0 1 2 3 4 5 6 Age 50 to less than age 60 Select 0 1 2 3 4 5 6 Age 60 or older Select 0 1 2 3 4 5 6
Have any of your children who have not been diagnosed with colorectal cancer been diagnosed with colorectal adenomatous polyps?	Please select Yes No Don't know
Please select the number of your children when diagnosed under each age range:
Under age 60 Select 0 1 2 3 4 5 6 Age 60 or above 60 Select 0 1 2 3 4 5 6
Have any of your sisters or brothers been diagnosed with colorectal cancer?	Please select Yes No Don't know
Please select the number of your sisters or brothers when diagnosed under each age range?
Under age 50 Select 0 1 2 3 4 5 6 Age 50 to less than age 60 Select 0 1 2 3 4 5 6 Age 60 or older Select 0 1 2 3 4 5 6
Have any of your sisters or brothers who have not been diagnosed with colorectal cancer been diagnosed with colorectal adenomatous polyps?	Please select Yes No Don't know
Please select the number of your sisters or brothers when diagnosed under each age range?
Under age 60 Select 0 1 2 3 4 5 6 Age 60 or above 60 Select 0 1 2 3 4 5 6
Questions about your second degree relatives, such as your grandparents, aunts, uncles, nieces, nephews, grandchildren and half brothers and sisters
Have any of your grandparents been diagnosed with colorectal cancer?	Please select Yes No Don't know
How many grandparents on your mother's side?	Please select 0 1 2
Were any of your grandparents on your mother's side under the age of 50 when diagnosed?	Please select Yes No Don't know
How many grandparents on your father's side?	Please select 0 1 2
Were any of your grandparents on your father's side under the age of 50 when diagnosed?	Please select Yes No Don't know
Have any of your grandchildren been diagnosed with colorectal cancer?	Please select Yes No Don't know
How many?	Please select 1 2 3 4 5 6
Were any of your grandchildren under the age of 50 when diagnosed?	Please select Yes No Don't know
Have any of your aunts or uncles been diagnosed with colorectal cancer?	Please select Yes No Don't know
How many aunts or uncles on your mother's side?	Please select 0 1 2 3 4 5 6
Were any of your aunts or uncles on your mother's side under the age of 50 when diagnosed?	Please select Yes No Don't know
How many aunts or uncles on your father's side?	Please select 0 1 2 3 4 5 6
Were any of your aunts or uncles on your father's side under the age of 50 when diagnosed?	Please select Yes No Don't know
Have any of your nieces or nephews been diagnosed with colorectal cancer?	Please select Yes No Don't know
How many?	Please select 1 2 3 4 5 6
Were any of your nieces or nephews under the age of 50 when diagnosed?	Please select Yes No Don't know
Have any of your half brothers and sisters been diagnosed with colorectal cancer?	Please select Yes No Don't know
How many half brothers and sisters on your mother's side?	Please select 0 1 2 3 4 5 6
Were any of your half brothers and sisters on your mother's side under the age of 50 when diagnosed?	Please select Yes No Don't know
How many half brothers and sisters on your father's side?	Please select 0 1 2 3 4 5 6
Were any of your half brothers and sisters on your father's side under the age of 50 when diagnosed?	Please select Yes No Don't know

Please complete the following optional fields before getting the result:

Last Name
First Name
Zip
Email
Date of Birth	Month January February March April May June July August September October November December Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012
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Yes, I would like to receive additional information from the Cleveland Clinic.

Thank you for answering all the necessary assessment questions! We recommend you review your selections carefully and then click the button to get your result.