Colonoscopies in Spotlight as Cases Rise in Younger Patients

By Pat Carragher - February 07, 2022

Colonoscopies typically aren’t a central topic of late-night talk shows, but actress Kristen Bell shed some light on the screenings in a recent interview. Bell appeared on “Jimmy Kimmel Live!”, telling the host about a recent trip to the doctor.

“I got my first elective colonoscopy,” said Bell. “I am 41, I was like, ‘Get in there. Let’s see what we got.’ ”


Kimmel replied he thought the age was 45 for people to get screened, and Bell said either way, she’s looking out for herself. Kimmel was correct. The American Cancer Society suggests first getting screened for colorectal cancer at age 45 unless you have a family history.

Is an elective colonoscopy something you should consider even if you don’t have a family history of colon cancer? According to Dr. Mark Friedman, a gastroenterologist in Moffitt Cancer Center’s Gastrointestinal Oncology Department, any test not done for an emergency is considered elective.  So almost all colonoscopies are elective.

“There are specific guidelines in place as to when to start your elective colonoscopies, what we call colon cancer screening guidelines,” said Friedman. “Yes, it is absolutely something that everyone should consider and follow through with. A colonoscopy has been proven to reduce the risk of colon cancer and it is critical to do it based on the guidelines put forth by the major medical societies.”

A recent study from the University of Colorado School of Medicine found that a growing number of young people are being diagnosed with late-stage colon cancer. Researchers looked at data from more than 100,000 people with adenocarcinoma. They found that patients ages 20-29 had the highest increase in new colon cancer cases and are more likely to be diagnosed with late-stage disease when cancer has already spread.

Does insurance cover colonoscopies?

Although many private insurance plans cover the costs for colonoscopy as a screening test, you still might be charged for some services. Review your health insurance plan for specific details. Before you get a screening colonoscopy, ask your insurance company how much (if anything) you should expect to pay for it. Find out if this amount could change based on what’s found during the test. This can help you avoid surprise costs.


After considering recent trends of increasing cases of colon cancer in younger people, the U.S. Preventive Services Task Force recommended that people of average risk start colorectal cancer screenings at 45 instead of 50.

According to a 2018 study from UC San Diego Health, 40% of people who are considered at risk for colorectal cancer have never been screened.

headshot of Dr. Mark Friedman
Dr. Mark Friedman, Gastrointestinal Oncology Department

“I think many people are unaware that they may be at risk for colon cancer or know that they need colon cancer screening,” said Friedman. “And I think that there are a lot of negative stigmata about getting a colonoscopy and this also stops people from getting the exam.  In actuality, it’s an extremely important test to prevent cancer and very easy and safe to do.”

At-home fecal immunochemical test, or FIT, kits are available by prescription through your doctor and offer simple directions on how to collect a stool sample and send it to a lab for analysis. The test looks for blood in the stool, which may be an early sign of colon cancer. It does not directly pick up polyps or cancer, like a colonoscopy, which is still considered the “gold standard” test for colon cancer screening, according to Friedman.

“We acknowledge that there are patients who would be high risk for the colonoscopy, or the sedation associated with the colonoscopy,” said Friedman. “We also know that there are patients who financially may not be able to afford a colonoscopy.  In these scenarios, we might suggest a cheaper or less invasive exam such as fecal based screening exams.”

In addition to identifying cancers, a colonoscopy can detect pre-cancerous lesions that may grow into cancer in the future.  It is also the preferred test for anyone who has gastrointestinal symptoms or is considered at increased risk for colon cancer.

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