At What Age Should You Get Your First Colonoscopy?

Colon cancer screening is a proven lifesaver. That’s because a colonoscopy can detect precancerous growths (polyps) that form in the colon (large intestine) and rectum, allowing the polyps to be safely and easily removed before they undergo cancerous changes or start to produce symptoms. Screening can also detect colorectal cancer in its earliest stages, when it is small, localized (hasn’t spread) and easier to treat. As a result, this important test can actually prevent the development of colorectal cancer, the third most common type of cancer diagnosed in the United States (excluding skin cancer).  

The current gold standard in colon cancer screening, a colonoscopy allows a physician to examine the interior of the colon and rectum with a thin, flexible scope that is inserted through the anus and used to transmit detailed images onto a nearby video screen. During the procedure, the physician can also insert small surgical instruments to take tissue samples (biopsies) or remove polyps or other abnormal tissues. Usually performed on an outpatient basis while a patient is under sedation, a colonoscopy is a relatively simple but comprehensive test that can both detect and prevent cancer.  

So, at what age has colonoscopy proven to be effective enough at preventing cancer to justify its routine use in the general population? Most experts agree that adults who have an average risk of developing colon cancer should have a baseline colonoscopy at age 50 and, if the results come back normal, a follow-up colonoscopy every 10 years thereafter.

However, 50 is not the magic number for everyone. Researchers have identified several risk factors that are believed to make some individuals more prone to developing colon cancer, and therefore may warrant testing at a younger age. These risk factors include:

• Having a first-degree relative (a parent, sibling or child) who was diagnosed with colorectal cancer or polyps – Individuals with a family history colorectal cancer or polyps may have an elevated risk of developing the condition themselves, particularly if a close relative was diagnosed at a young age. As a general rule of thumb, these individuals should begin screening 10 years before the age of the youngest case in his or her immediate family. For example, if an individual’s parent was diagnosed with colon cancer at age 45, that individual should have his or her first colonoscopy by age 35.
• Being of African-American descent – Due to a disproportionately higher incidence of colon cancer among the African-American population, some physicians recommend a baseline colonoscopy at age 45 or earlier for African-Americans.
• Having certain hereditary conditions – Individuals who were diagnosed with familial adenomatous polyposis, hereditary nonpolyposis colon cancer (Lynch syndrome) or other inherited conditions may have a heightened risk of developing colorectal cancer. For these individuals, a physician may recommend earlier screenings on a case-by-case basis.  

The bottom line is that everyone should be screened for colorectal cancer according to the individual guidelines recommended by a physician. Colon cancer can be one of the most preventable types of cancer – if a patient takes a proactive role in his or her own health care.  

To speak with a physician at Moffitt Cancer Center about colorectal cancer screening recommendations, call 1-888-663-3488 or complete a new patient registration form online.  No referrals are required.