It’s Time for a Colonoscopy if You’ve Turned 45

The American Cancer Society now recommends that people with an average risk for colorectal cancer start getting screened at age 45.

It’s a sign that you’re middle-aged when your doctor recommends that you get your first colonoscopy. The procedure checks your colon through your large intestine for signs of polpys or colorectal (colon) cancer.

In 2018, the American Cancer Society began recommending that people with an average risk for colorectal cancer start being screened at age 45. Previously you could wait until you were 50, but more younger people have been getting the disease.

The U.S. Preventive Services Task Force (USPSTF), a team of 16 volunteer experts (the task force is not a governmental agency)also recommends that screening start when you turn 45.

Although most cases of colon cancer occur between the ages of 65 and 74, close to 11 percent of new patients are 50 or younger. Rates among people in their 40s have increased by almost 15 percent since the early 2000s.

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What is a colonoscopy?

You’ll get instructions on what to eat or drink beforehand and any laxatives you need to take. The procedure lasts about 30 to 60 minutes. You’ll be injected with medication and asked to lie on your left side on an examining table. Your doctor will insert a colonoscope into your rectum. The device is about a half inch wide and will blow air into your colon. It contains a small video camera at the tip that allows your doctor to see inside and take images of the lining to be examined later.

The scope bends, so your doctor can move it where your colon curves. You may need to change your position. Some people feel mild cramps, which you can calm with slow, deep breaths.

If your doctor sees anything abnormal, he or she can remove small amounts of tissue for analysis (called a biopsy). Your doctor can also remove growths called polyps.

This may seem like too much trouble, but more than 50,000 people in the United States die of the disease each year, the task force reported. Men are more at risk. So are blacks, Native Americans, and people with a family history of colorectal cancer or risk factors like obesity, diabetes, or a history of smoking or overdrinking alcohol.

Did you have your colonoscopy?

The American College of Physicians recommends having a colonoscopy every 10 years if you are 50 to 75 years old and have an average risk of colorectal cancer and a life expectancy of at least 10 more years. If you’re at increased risk, you may need to be screened every one to five years. Increased risk can include having a polyp removed, a prior history of colon cancer, and a family history of the disease.

Even among people 50 and older, about a third haven’t been getting regularly screened.

It’s possible to screen for signs of colorectal cancer in other ways. You can have your stool checked for blood every year. A procedure called flexible sigmoidoscopy could be a first step, followed by colonoscopy only if precancerous polyps are detected and need to be removed.

The USPSTF still recommends that adults ages 76 to 85 should be screened based on individual considerations, and that routine screening stop after 85.

How to lower your risk of colorectal cancer

• Eat lots of vegetables, fruits, and whole grains.
• Get regular exercise.
• Lose extra pounds.
• Don't smoke.
• Stay away from alcohol.

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