Should I Get A Colonoscopy?

Posted Jan 8 2025

A colonoscopy is a medical procedure that allows doctors to examine the inside of your colon and rectum for signs of abnormalities, such as polyps, tumors, or early-stage cancers. While the idea of the procedure can be intimidating for some, it plays a crucial role in preventing colorectal cancer and diagnosing other gastrointestinal conditions early, when they are more treatable.

But the question remains: When should you get a colonoscopy? In this article, we'll explore the general guidelines, risk factors, and signs that indicate it might be time to schedule this important screening.

Understanding the Importance of a Colonoscopy

Colorectal cancer is the second most common cancer in both men and women in the United States, but it is also one of the most preventable cancers. Many colorectal cancers develop from small, non-cancerous growths called polyps, which can be removed during a colonoscopy before they have a chance to turn into cancer. Screening for colorectal cancer can also help detect other conditions such as inflammatory bowel disease (IBD), diverticulosis, or gastrointestinal bleeding.

The key to successful treatment and prevention is early detection. That’s why colonoscopies are recommended at certain intervals, depending on your age, risk factors, and family history.

When Should I Get a Colonoscopy? General Guidelines

1. Starting at Age 45: Standard Screening for Average-Risk Individuals

For most people with no symptoms and no family history of colorectal cancer or other risk factors, the American Cancer Society (ACS) recommends starting routine screening at age 45. This is a significant shift from the previous age of 50, which was updated in 2021 due to an increasing number of colorectal cancer cases in younger individuals.

After the initial screening, individuals at average risk should get a colonoscopy every 10 years, assuming the results are normal and there are no other concerns.

2. Earlier Screening for High-Risk Individuals

While the standard recommendation is 45, people with a higher risk of colorectal cancer may need to start screening earlier and/or undergo screening more frequently. High-risk factors include:

• Family History: If you have a first-degree relative (parent, sibling, or child) who has been diagnosed with colorectal cancer or polyps before the age of 60, or if two or more close relatives have had the disease at any age, you may need to start screenings earlier—often at age 40 or 10 years before the age of diagnosis of the affected family member, whichever is earlier.
• Personal History of Polyps: If you’ve had adenomatous polyps (precancerous growths), you’ll likely need more frequent colonoscopies. The timing will depend on the number, size, and type of polyps found.
• Personal History of Colorectal Cancer: If you’ve been diagnosed with colorectal cancer in the past, you will need regular follow-up colonoscopies, usually starting within a year after treatment and continuing at intervals determined by your doctor.
• Inflammatory Bowel Disease (IBD): Conditions like Crohn’s disease and ulcerative colitis can increase your risk for colorectal cancer. If you have IBD, your doctor will likely recommend more frequent screening starting after 8–10 years of having the disease.
• Genetic Syndromes: Certain inherited genetic conditions, such as Lynch syndrome or familial adenomatous polyposis (FAP), significantly increase the risk of colorectal cancer. If you have one of these syndromes, you will need to start screening in your teenage years or early twenties, with screenings occurring more frequently throughout life.

3. Screening for Symptoms

In addition to routine screening, you may need a colonoscopy if you experience symptoms that could indicate problems in the colon. These symptoms include:

• Changes in bowel habits (persistent diarrhea or constipation)
• Unexplained weight loss
• Blood in the stool or black, tarry stools
• Abdominal pain or cramping
• Fatigue or weakness (which could signal anemia due to internal bleeding)

If you notice any of these symptoms, it's important to speak with a healthcare provider right away, even if you're not yet at the recommended screening age. While these symptoms don’t always point to cancer, they could signal other conditions that require attention.

What Happens During a Colonoscopy?

A colonoscopy is performed by a gastroenterologist, a specialist in digestive health. During the procedure, a long, flexible tube with a camera (called a colonoscope) is inserted through the rectum to examine the lining of the colon. The procedure typically takes between 30 minutes and an hour and is done under sedation, so you’ll be relaxed and comfortable.

If any abnormal growths, polyps, or tissue are found, your doctor may remove them during the procedure or take a biopsy for further examination.

Potential Risks of a Colonoscopy

Although colonoscopies are generally safe, there are some risks involved, such as:

• Bleeding (especially if a polyp is removed)
• Perforation (a tear in the colon wall)
• Infection

However, the risks are low, and the benefits of early detection far outweigh these potential complications, particularly for those at increased risk of colorectal cancer.

Preparing for a Colonoscopy

Proper preparation is essential for a successful colonoscopy. You will need to clean your colon thoroughly so the doctor can get a clear view. This usually involves following a specific diet for a few days before the procedure and drinking a special liquid (laxative) to induce bowel movements. It's crucial to follow the preparation instructions carefully, as insufficient bowel cleaning can lead to inaccurate results or the need for a repeat procedure.

The Bottom Line: When Should You Get a Colonoscopy?

To summarize, here are the general recommendations for when to get a colonoscopy:

• Age 45: For individuals with average risk and no symptoms. Repeat every 10 years.
• Earlier if high risk: If you have a family history of colorectal cancer, a personal history of polyps or cancer, or certain genetic conditions, start screening earlier—usually between ages 40 and 50. The frequency will depend on your risk.
• For symptoms: If you experience unusual gastrointestinal symptoms, it’s important to consult a healthcare provider, even if you're under the typical screening age.

Regular screening for colorectal cancer can save lives by detecting problems before they become serious, and many polyps can be removed before they turn into cancer. If you’re unsure about your personal screening schedule, it's best to talk to your doctor, who can assess your health history and recommend the appropriate plan for you.

Remember: Preventive care is one of the most powerful tools in maintaining good health—don’t delay a colonoscopy if you’re due for one, or if you fall into a high-risk category. It could make all the difference in catching potential issues early, when they are most treatable.

Book your appointment today because you may qualify for a free Colonoscopy Screening by enrolling into a Health Insurance Plan!