A family history of colorectal cancer (CRC) in a first-degree relative increases one’s average lifetime risk of CRC.1–3 The magnitude of the risk increase is affected by the age of the individual, age of the affected relative, number of affected relatives, and degree of familial relation.2,4 Guidelines currently recommend early initiation of screening colonoscopy (at age 40 or 10 years before the age of CRC diagnosis in the youngest affected relative), and surveillance intervals which depend on the age and number of affected first-degree relatives.