Who should get a colonoscopy?

Generally it’s recommended that everyone over 50 get a colonoscopy. A family history of colon cancer and being African-American raises your risk and you should consider earlier screening.

All Americans over the age of 50 should get a colonoscopy—the gold standard for colon cancer screening. In this video, Sharmila Anandasabapathy, MD, a gastroenterologist, explains why some people might get tested earlier.

Dr. Joseph W. Beets, MD

Anybody having problems with a change in bowel habits—diarrhea or constipation, rectal bleeding, or other problems—should be referred for assessment. Regardless of age, people having problems should be seen and evaluated. Colonoscopy can often allow diagnosis and specific treatment.

The more common question is about “screening colonoscopy.” Screening is done in a person who isn’t having any symptoms or problems. We know that colon polyps are very common (25 30 percent of the population). Colon cancer is also common (#2 cancer killer in United States).

Neither polyps nor cancers cause symptoms until very late in the process. Screening colonoscopy allows us to find polyps, and even early cancers, that would never be detected by routine doctor visits. Removal of polyps can prevent colon cancers.

Current screening guidelines suggest that people of average risk (most people), should have colonoscopy at 50 years of age. If colonoscopy is normal, then repeat every 10 years. If “adenomatous” polyps are found then repeat at 3 to 5 year intervals depending upon the number and characteristics of the polyps. Remember, these are people without any gastrointestinal problems.

People defined as “high risk” should start getting colonoscopies earlier. High risk patients include people with: personal history of colonic polyps (specifically “adenomatous polyps”), family history of colon cancer and other conditions. “High risk” patients should get colonoscopy at 40 years of age, or 10 years before a family member was diagnosed with colon cancer (whichever is earlier). Depending upon findings, “high risk” patients are typically studied every 3 to 5 years.

You should ask your doctor about situations that might place you at higher than average risk for colon polyps and colon cancer.

The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Dr. Elif E. Oker, MD
Medical Toxicologist

Colonoscopy is recommended to screen for colon cancer in adults beginning at age 50. However, if you have a family history of colon cancer or certain types of colon polyps, then you may need to begin screening for colon cancer at an earlier age. Your doctor can help you decide the best time to start colon cancer screening.

A colonoscopy is a recommended screening procedure starting at age 50.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.