Doctors used to recommend starting colon cancer screening from the age of 50. However, recent guidelines from the US Preventive Services Task Force (USPSTF) and the American Cancer Society recommend starting screening from 45 years of age. Yes, you read that correctly—45 is the new 50. Keep reading to learn the details.
In this post, we’ll take a deeper look into screening for the third most common cancer out there and discuss the following:
- Colon cancer screening recommendations for average- and high-risk patients
- Screening recommendations for women
- At the youngest age, you can get screened for colon cancer
- The signs of needing a colonoscopy
What is the best age to get a colonoscopy?
The best age for getting a colonoscopy for average-risk patients is 45 years of age, regardless of symptoms or negative family history, followed by a regular screening at least every 10 years, depending on findings. Average-risk patients are those who:
- Don’t have a family history of cancer
- Don’t have a past history of colon cancer
- Are not suffering from a colon cancer-promoting disease, such as inflammatory bowel disease (IBD)
- Have not been diagnosed with precancerous polyps, which are tiny growths in the gut that can turn into cancer
However, some colon cancer screening guidelines still recommend 50 years as the starting point for colon cancer screening.
This means if you’re 45 years of age, you should definitely talk to your doctor about a screening colonoscopy. However, because some guidelines still recommend screening at 50 years of age, your doctor might ask you to wait based on their experience and hospital guidelines and check with your insurance plan to see if they will cover colonoscopy at age 45 per the newest guidelines.
For patients with a high risk of colorectal cancer, the best age to get a colonoscopy varies according to their risk factors. Here are the recommended times for different conditions:
- Peutz-Jeghers syndrome: 8 years old
- Familial adenomatous polyposis: 10-15 years old
- Ulcerative colitis: 8-10 years after the initial diagnosis and based on symptoms
- Crohn’s disease: 8 years after the disease started (if more than 30% of the colon is affected) and based on symptoms
- Positive family history of colon cancer: 40 years of age or 10 years earlier than the relative’s diagnosis, whichever is younger
All of these conditions put you at an increased risk of colon cancer than the average person, which is why screening in these cases is started even before 45 years.
What is the youngest age to get a colonoscopy?
The youngest age to get a screening colonoscopy is 8 years old for those with Peutz-Jeghers syndrome. This condition is a hereditary disorder that causes polyps in the gastrointestinal system.
For average-risk patients, 45 is the youngest age to get screened for colon cancer.
However, keep in mind that we’re talking about a screening colonoscopy in the context of colon cancer. There are many other conditions — such as IBD and diverticular disease — that require a colonoscopy for diagnosis and treatment.
In these cases, there is no fixed age and a colonoscopy may be recommended sooner depending on circumstances.
At what age should a woman get a colonoscopy?
An average-risk woman should get a screening colonoscopy at 45 years of age, just like average-risk men.
It’s a common misconception that colon cancer is a male disease. But this is not true. For instance, colorectal cancer accounted for 8% of all cancers in both American males and females in 2020.
Similarly, deaths from colorectal cancers accounted for 8% of all cancer deaths in women and 9% of all cancer deaths in males.
This means colorectal cancer rates are similar for men and women, and gender is not a good reason for avoiding a colonoscopy.
What are the signs of needing a colonoscopy?
The signs of needing a colonoscopy depend on the condition and symptoms. Generally, symptoms that might require you to get a colonoscopy includes the following:
- Anemia
- Rectal bleeding
- Unexplained fatigue
- Abdominal or rectal pain
- Unexplained weight loss
- Change in bowel habits
Keep in mind that even if you don’t have any of these symptoms and are completely healthy, you should still get a screening colonoscopy at 45 years of age.
Is a colonoscopy the only way to screen for colon cancer?
No, a colonoscopy is not the only way to screen for colorectal cancer. Current guidelines emphasize the importance of shared-decision making and taking patient preferences into account when choosing a screening method.
Other ways to screen for colon cancer include:
- CT colonography: This is also known as a virtual colonoscopy and it’s where doctors use a CT scan to look for polyps or abnormalities in the colon.
- Flexible sigmoidoscopy: This is similar to a colonoscopy, but it looks at only the lower part of the colon.
- Stool-based screening tests: These include fecal immunochemical testing — which detects blood using antibodies — and fecal occult blood testing or stool DNA studies.
But keep in mind that the gold standard for colorectal cancer screening is still a colonoscopy. If you get a positive result on any of these alternatives, you will ultimately need to undergo a colonoscopy with possible biopsy.
The FDA approved a home colon cancer screening test — Cologuard — in 2014.
It looks for DNA mutations, abnormal cells, and blood in your stool to detect cancer. However, we don’t recommend Cologuard because it’s not as sensitive and accurate as a colonoscopy, especially in high-risk patients.
Is colonoscopy required for piles or hemorrhoids?
No, a colonoscopy is not usually required for hemorrhoids (piles). While it’s possible that your doctor might recommend a colonoscopy if you have symptoms such as bleeding or pain, it’s more likely that they will recommend an anoscopy.
An anoscopy is a mini-version of a colonoscopy that uses a small, lighted tube to examine the last part of the rectum and anus. It can help determine if piles or fissures are the source of your symptoms.
Colonoscopy Ages Summarized
At the youngest, a screening colonoscopy for average-risk individuals should be done at age 45.
But if you have certain symptoms or a cancer-promoting condition, your doctor may recommend a colonoscopy sooner.
It’s important to talk to your doctor about your individual risk and preferences for screening. Other ways to screen for colon cancer include CT colonography, flexible sigmoidoscopy, and stool-based testing.
However, the gold standard for colorectal cancer screening is still a colonoscopy.
If you have any questions or concerns about colorectal cancer screening, feel free to reach out to us. We’ll be happy to help!
