5 Must-Know Facts About Colonoscopies

5 Must-Know Facts About Colonoscopies

If you’re over age 50 and haven’t had a colon cancer check, you’re not alone. A whopping 23 million Americans have never had a proper test for this killer, a sobering new report reveals. This is one club you don’t want to be a member of. Here’s how to get out—and save your life.

Colorectal cancer claims 50,000 lives annually. But 60 percent of these deaths could be prevented if tiny growths on the lining of the intestines, called polyps, were spotted and removed during a colonoscopy. Most polyps are either non- or precancerous or in early stages of gastrointestinal cancer.

Colonoscopy, the gold-standard gut-check, is recommended when you hit age 45 or 50 (or perhaps younger if this cancer runs in your family) and every 10 years after that if no problems are seen. But a third of you have never had any kind of colon cancer screening. And we sympathize—they’re intrusive and scary (both of us had polyps removed at age 50 during a simple colonoscopy)—but battling advanced colon cancer is a whole lot more frightening. So, here’s how to get past common fears that may be keeping you from getting a life-saving colon check.

Fear #1: It’ll hurt.
Fact: Most, if not all, colonoscopies are done under mild sedation using the drugs fentanyl and/or midazolam. You'll feel nothing as go into in a light sleep. Your privacy, modesty and dignity get plenty of respect, too.

Fear#2: "Bowel prep" is a pain in the…
Fact: Your doc needs to see every inch of your colon, without an obstructed view. At best, incomplete prep boosts your odds for a do-do-over; at worst, it ups the risk for undetected polyps and missed cancers. Sure, the prep may keep you home for a while, but try to schedule your colonoscopy for a Monday morning; then you can spend Sunday around the house.

Fear#3: I’m scared they’ll find something.
Fact: Colon polyps are super-common—30 to 50 precent of adults have at least one; less than 10 precent are precancerous. If you’ve got a polyp, finding it and having it removed during your colonoscopy is the best thing that can happen to you.

Fear#4: Colon cancer runs in my family. I’m afraid I’ll find out I have it, too.
Fact: If a close relative (mom, dad, sister, brother, or child) had colon cancer, that boosts your risk by 35 to 70 precent. Your doc should advise you to start having colon checks at age 40. If any close relative were diagnosed before age 44, then you should begin getting colonoscopies five years before the age he or she was diagnosed. Also, ask about having those earlier checks if more distant relatives (aunt, uncle, cousin or grandparent) were affected. One new report says waiting until age 50 could miss 10 precent of early cancers in this population. If you have colon cancer, you want to know now, not later when it's harder to successfully treat.

Fear#5: I can’t afford it.
Fact: About one in four people who skip colon checks have no insurance. But thanks to changes in federal health laws, more insurance policies will cover the costs (with no co-pay, thanks to the Affordable Care Act) in 2014. In addition, the federal Colorectal Cancer Control Program could help pay for yours. Learn more at

If you can't handle the procedure, you do have options even if they aren't the gold standard. Your best option is a high-tech, at-home test. The latest at-home colon-cancer check, the fecal immunochemical test (FIT), sleuths for blood hidden in stool—a warning sign for polyps. Just take a sample from two bowel movements and get them to your doc or lab pronto. There is no prep, it’s cheap (about $22 per test) and nearly as accurate as a colonoscopy—but you need to do it every year. If blood is found, then you’ll need a colonoscopy or sigmoidoscopy (a scan of the large intestine).

Medically reviewed in December 2019.

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