If anyone in your family has had colon cancer, or if you’re nearing the age of 45, you’ve probably already been told about the importance of scheduling a colonoscopy. You may even have grown tired of your doctor telling you that it’s something you need to consider.
But the prospect of having your bowels explored on camera doesn’t exactly have most people running to book an appointment. According to the Centers for Disease Control and Prevention (CDC), less than half of adults in their early 50s have had a colonoscopy or any type of colorectal cancer screening.
This is bad news because colorectal cancer is the second most common cause of cancer death in the United States. A colonoscopy—a procedure doctors use as a tool to diagnose and screen conditions of the colon—is particularly useful for its early diagnosis. When colon cancer is found in its early stages, the five-year survival rate is 90%, according to the American Cancer Society.
Unfortunately, 4 out of 10 cases of colon cancer are found when cancer has already spread to other areas of the body. Rates of colon cancer are also rising significantly in younger people, according to 2020 statistics published in CA: A Cancer Journal for Clinicians.1 That’s why, beginning in 2016, the American Cancer Society recommends anyone with average risk to start screening for colon cancer at age 45, or sometimes earlier depending on personal health history.
Colon cancer isn’t the only condition that a colonoscopy can catch, though. Ulcerative colitis and Crohn’s disease, both autoimmune conditions that fall under the umbrella of inflammatory bowel disease (IBD), can be detected with this test. If you’ve already been diagnosed with one of these conditions, you do have an increased risk of colon cancer, so getting regular screenings is especially important, according to a 2018 study published in the journal Clinics of Colon and Rectal Surgery.2
SELF spoke with doctors who perform colonoscopies to give us the details on what they wish people knew about this potentially life-saving screening procedure.
What is a colonoscopy, exactly?
A colonoscopy basically is what it sounds like: a camera (scope) on a flexible rod explores your large and small intestine, looking for inflammation and pre-cancerous lesions called polyps that can grow on your intestinal walls, Matthew Bechtold, MD, a practicing gastroenterologist and professor of clinical medicine at the University of Missouri, tells SELF.
“The whole idea of screening is to prevent colon cancer from forming,” Dr. Bechtold says. “With screening, you can go in and take out these polyps or growths. Those polyps would otherwise likely grow into colon cancer over 5 to 15 years. So that’s why we want to go in there, find them, and take them out before they even have a chance of becoming colon cancer.”
If a polyp is spotted during the course of a colonoscopy, it gets removed and retrieved for further testing. If you do have one (or a few) removed, don’t worry. Polyps are common, and many found during a colonoscopy are later determined to be benign, according to a 2016 study published in the World Journal of Gastroenterology.3
Colonoscopies are also the go-to diagnostic test for conditions that affect your lower bowel, including Crohn’s disease, ulcerative colitis, and others. Your doctor might take a biopsy—remove a small piece of tissue—in your colon, which will then be looked at closely in a lab. They’ll check for signs of inflammation or changes associated with IBD.
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When should you get a colonoscopy?
The answer varies, but in general if you are considered “average” risk of colon cancer—that is, you don’t have a history of bowel disease, a family history, or symptoms of concern, such as abdominal pain—it is advised that you get your first colonoscopy at or around age 45, says Keri Pinnock, MD, a gastroenterologist at Austin Regional Clinic in Texas.
Dr. Pinnock adds that if you have a history of colon cancer in your immediate family—that means a parent or sibling—you may be recommended to start getting screened earlier. “If your family member was diagnosed before 60, the guidelines are that you are recommended to have a colonoscopy at age 40 or 10 years prior to the age that that family member was diagnosed with colon cancer, whichever i