When to get a colonoscopy: Age, family history, & symptoms

Most will agree that a colonoscopy is the gold standard for colon cancer screening. I am pleased with recent studies which reveal that colon cancer incidence rates have dropped 30% in the U.S. in the last 10 years among adults 50 and older due to an increase in colonoscopy screenings. This leads to the question: when should you get a colonoscopy? While most people should begin at age 50, there are exceptions. Let’s take a look at the factors which determine how soon and how often to get a colonoscopy.

When to get your first colonoscopy screening

A person with average risk for colon cancer should begin screening at age 50 and have screenings once every ten years until about age 80. African Americans should start screenings at age 45. Recommendations for follow up colonoscopies can change, of course, based on the patient’s health, especially if he or she has significant health issues. Assuming each exam comes back with no worrisome results, this process is fairly simple.

When to get a colonoscopy if you are a high risk patient

Some patients are at a higher risk of developing colon cancer and may require a first colonoscopy earlier than age 50 and/or the next colonoscopy at shorter intervals. People at higher risk include:

• Someone who has already been screened and polyps have been found – It’s important that these patients have their next colonoscopy in about five years (or sooner), depending on the size and type of polyp(s) found.
• Someone with a family history of cancer, especially colon cancer – Screenings for these patients should begin 10 years prior to the youngest diagnosed case of cancer in the family or age 40, whichever is earlier.
• Someone with a first degree (mother, father, sibling) family member who had colon polyps or cancer – Screenings for these patients should begin 10 years prior to the youngest diagnosed case of polyps or cancer in the family or age 40, whichever is earlier.
• Someone who has IBD – also called Inflammatory Bowel Disease – The most common types of this disease are Crohn’s Disease and Ulcerative Colitis. If the patient has Crohn’s Disease, the first screening should begin 15 years after initial diagnosis of the condition (or age 50 if that comes first) and then repeated every 1-3 years. If the patient has Ulcerative Colitis, the first screening should begin 8 years after initial diagnosis of the condition (or age 50 if that comes first) and then repeated every 1-2 years.
• Someone who has been diagnosed with endometrial cancer at a young age or HIV infection (males only) or someone who has had radiation for prostate cancer – Early studies indicate that these groups of patients may carry a higher risk of developing colon cancer. We are watching the research closely.

When symptoms require a colonoscopy

Even if a patient doesn’t fall into the “high risk” category, there are certain symptoms that would require a diagnostic colonoscopy in order to evaluate colon health. Rectal bleeding, severe abdominal pain, diarrhea, changes in bowel movements and bloating are all red flags. These symptoms could be a sign of something else, such as Inflammatory Bowel Disease, but it is important to rule out colon cancer as a potential cause. You should tell your doctor if you are experiencing these symptoms.

Take steps now to reduce your risk of colon cancer

Ultimately, we do not want to wait for colon cancer symptoms to occur. Proper screening increases the chance that we can identify a polyp before it becomes cancerous or identify colon cancer in the early stages when treatment is most effective.

In addition to regular colonoscopies, there are lifestyle changes you can make to reduce your risk of colon cancer:

• Eat a diet rich in fruits and vegetables.
• Stay active.
• Avoid smoking or if you currently smoke, do all you can to quit.
• Drink alcoholic beverages in moderation or if possible, abstain.

Is it time for you to be screened for colon cancer? Contact Richmond Gastroenterology to schedule your colonoscopy.

Disclaimer: This blog article is intended to be informative and is not medical advice.