You'll Need Your First Colonoscopy Sooner Than You Think

Photo:  Sen Alfred (Shutterstock)
Photo: Sen Alfred (Shutterstock)

Colonoscopies are no fun. Prepping for one includes a full day of eating nothing but liquid and laxatives, with the goal of emptying everything out of your bowels in under 24 hours. Then, once your guts are completely empty, you’re sedated so that doctors can stick a flexible camera up your rear to take images of your anatomy that normally would never, ever see the light of day.

As unpleasant as the experience is, colonoscopies are a hugely valuable tool in catching colon and rectal cancers earlier, when treatment is far more effective. Given that colorectal cancers are the fourth-leading cause of cancer deaths in the United States, catching it earlier than later is hugely important.

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Colon cancers in young people are on the rise

In 2010, 5% of colon cancers and 9% percent of rectal cancers were in patients younger than 50. In 2020, these numbers have risen to include 11% of colon cancers and 15% of rectal cancers being found in patients younger than 50. Doctors still don’t know why these numbers are rising, but it’s concerning, especially since these are slow-growing cancers that, if caught early enough, are very treatable.

Given that the survival rates for these cancers are much better the earlier they are caught, there’s been a recent change in the screening guidelines. Now, instead of scheduling your first colonoscopy at 50, they’re recommending starting at age 45.

The different types of colon cancer screenings

You may have heard about other ways of screening for colon cancer, like stool tests. As of right now, there are three approved stool tests, which work by detecting components of hemoglobin, or antibodies to hemoglobin, along with certain DNA biomarkers. These tests are useful, but they can’t quite replace colonoscopies, though, as the stool tests need to be done every few years and are known to generate false positives. If you do have a positive result on a stool test, then the next step will be to get a colonoscopy, anyway.

The big advantage of doing a regularly scheduled colonoscopy is that they only need to be done every ten years. If doctors do find a polyp, which are slow-growing clumps of cells that, over time, can develop into colon cancer, they can also often be removed during the procedure itself. Given that 40% of adults over the age of 50 have polyps, there’s a pretty reasonable chance that at some point down the road, you may need to have some removed as well.


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