What is a Colonoscopy and Who Needs It To Get It Done?
A colonoscopy is an exam where a long, flexible tube known as a colonoscope is inserted into the rectum. The tube has a small video camera attached at one end, which allows the doctor to get a complete view of the inside of the entire large intestine or colon. This bendable tube looks for any type of abnormalities in the colon. A colonoscopy is the main exam used to check for the presence of colorectal cancer. This procedure is also used for conducting biopsies, in which a tiny piece of tissue is removed from the colon and sent to the laboratory for further analysis. This is done if your doctor suspects that the tissue could be cancerous or diseased. If required, any type of abnormal tissue or polyps can also be taken out through the colonoscope during this procedure.(1, 2, 3)
When it comes to who needs to get a colonoscopy done, well then, by the time you reach the age of 50, you should start having one colonoscopy once every ten years. This is true regardless of what your gender is or even if you are in excellent health.(4)
This is because as you get older, the risk of developing bowel cancer and polyps goes up substantially. Getting regular colonoscopies done helps your doctor detect any kind of abnormality well in time and in the early stages. This makes it possible to quickly seek treatment as well.(5)
In fact, it can be helpful to get colonoscopies at an earlier stage in life, especially if you have a family history of bowel cancer or you have had other conditions in the past that affected your digestive systems, such as colorectal polyps, inflammatory bowel disease or irritable bowel syndrome.
If you are at a very high risk of bowel conditions, you should consider getting a colonoscopy done more than once every year. The same holds true if you frequently experience symptoms that lead to your bowels becoming inflamed or irritated.
Your doctor may recommend a colonoscopy in the following instances:
Investigate any signs and symptoms of abnormalities in the intestines. A colonoscopy can help your doctor find out the possible causes of rectal bleeding, abdominal pain, chronic diarrhea, and other types of intestinal problems as well.
A colonoscopy is used to screen for colon cancer as well, especially if you are 45 years old or older and are at an average risk of developing colon cancer. If you have no risk factors for developing colon cancer except for your age, your doctor is likely to recommend that you get a colonoscopy once every ten years.
A colonoscopy is also done to look for polyps, which are tissue growths that appear like small, flat bumps and are small clumps of cells that usually develop on the lining of the rectum or colon. If you have had polyps before, your doctor may recommend a follow-up colonoscopy to check if the polyps have returned and also remove any additional growth. Polyps are removed to reduce the risk of colon cancer.(6, 7)
In some cases, a colonoscopy is recommended for treatment purposes, for example, for removing an object from the colon or for placing a stent.
When To Get Your First Colonoscopy?
Experts usually recommend that you undergo your first colonoscopy after turning 50 years if you are generally in good health and there is no family history of any type of bowel cancer or other types of bowel diseases. However, according to the set of guidelines being drafted by experts under the US Preventive Services Task Force (USPSTF).(8)
You should ideally schedule a colonoscopy as many times as recommended by your doctor, especially if you have been diagnosed with a bowel disease like ulcerative colitis or Crohn’s disease. This helps ensure that the condition does not progress and your bowel remains healthy. At the same time, regular colonoscopies in such cases can ensure that any complications that arise get treated at the earliest possible.(9, 10)
You should enquire from your doctor during your annual physical exams about when you should have a colonoscopy, especially if you are over the age of 50 or if you already have a bowel condition. This will allow your doctor to keep an eye on the condition of your colon and also understand your overall health risks.
How Often Should You Get A Colonoscopy If There Is A Family History Of Bowel Cancer?
According to experts, no age is considered to be too early for getting a colonoscopy if there is a history of bowel cancer in your family. According to the American Cancer Society, you should start having regular colonoscopies as soon as you turn 45 years if you even have a slight risk for cancer.(11) An average risk of cancer refers to 1 out of 22 in men and 1 out of 24 in women.(12)
For those with a higher risk or if you have had bowel cancer before, then you have to start getting colonoscopies regularly at an even earlier age. Some doctors even recommend high-risk individuals to start getting colonoscopies for cancer screening as early as 35 years, especially if a parent has been diagnosed with colorectal cancer in the past.(13)
It is important to note that if there is no diagnosis of cancer, some insurance companies might restrict the number of colonoscopies you can get in a year. And if you get screened at 35 years of age, it is possible that your insurance company may not cover another colonoscopy until you turn 40 or even 45. This is why it is a good idea to always research your insurance coverage before booking your colonoscopy.
How Often Should You Get A Colonoscopy If You Have Diverticulosis?
For those who have diverticulosis, doctors usually recommend getting a colonoscopy done once in every five to eight years. Your doctor will be the right person to ask about how frequently you need to get a colonoscopy done, as the exact frequency depends on the severity of your diverticulosis symptoms.(14)
How Often Should You Get A Colonoscopy If You Have Ulcerative Colitis?
Doctors typically recommend that people with ulcerative colitis should opt for having a colonoscopy once every two to five years. Remember that your cancer risk goes up around eight to ten years after getting your ulcerative colitis diagnosis. This is why it is necessary to keep getting regular colonoscopies.(15)
How Often Should You Get A Colonoscopy If You Have A Polypectomy?
Polyps are usually harmless and are easy to remove. However, certain types of polyps known as adenomas are known for being prone to becoming cancerous and should be removed. A polyp removal surgery is known as a polypectomy, and this procedure is usually done during a colonoscopy itself if your doctor detects a polyp.
If you have had a polypectomy, doctors usually recommend getting a colonoscopy done at least once in five years following the polyp removal surgery. If you are at a high risk for developing adenomas, you might need another colonoscopy after two years.(16)
How Often Should You Get A Colonoscopy If You Are 50 and Older?
After the age of 50 years, most people should ideally get a colonoscopy scheduled at least once in every ten years. After turning 60, you should get one done in every five years as the risk of cancer increases with age. After turning 80 years (or sometimes even 75), your doctor might say that you can no longer undergo the procedure as the risk of complications from a colonoscopy outweighs the benefits of this examination as you get older.(17)
Are There Any Risks To Getting A Colonoscopy?
Colonoscopies are routine exams and are generally considered to be safe and noninvasive. Nevertheless, there are some risks associated with the procedure. Nevertheless, what is essential to understand here is that most of the time, the benefits of getting a colonoscopy to identify and treat bowel diseases and cancer far outweigh the risks of getting a colonoscopy.
Some of the common side effects and risks associated with getting a colonoscopy include the following:
- Sharp pain in the abdomen.
- Internal bleeding from the place where a polyp or abnormal tissue was removed.
Some of the rare side effects or risks of a colonoscopy include:
- Perforation, injury, or tear to the rectum or colon. This is so rare that it happens in less than 0.002 percent of all colonoscopies.(18)
- Heart failure due to a reaction to the substances used during the procedure.
- Need for an emergency surgery to repair any damaged tissue.
- Adverse reaction to the sedative or anesthesia being used.
If your doctor finds you to be at a high risk for these complications, they might carry out a virtual colonoscopy where 3D images of your colon and taken and then examined on a computer.
If you are in good health, you will most likely need to undergo a colonoscopy only once every ten years after turning 50. However, the frequency of getting colonoscopies increases with many factors, including age and your risk of getting bowel cancer. You should discuss the need for getting a colonoscopy with your doctor if there is a history of bowel conditions in your family, if you have previously had polyps or bowel/colon cancer, or if you are at a high risk of developing colon cancer.
- Williams, C. and Teague, R.H., 1973. Colonoscopy. Gut, 14(12), p.990.
- Rex, D.K., Schoenfeld, P.S., Cohen, J., Pike, I.M., Adler, D.G., Fennerty, M.B., Lieb, J.G., Park, W.G., Rizk, M.K., Sawhney, M.S. and Shaheen, N.J., 2015. Quality indicators for colonoscopy. Gastrointestinal endoscopy, 81(1), pp.31-53.
- Waye, J.D., Lewis, B.S. and Yessayan, S., 1992. Colonoscopy: a prospective report of complications. Journal of clinical gastroenterology, 15(4), pp.347-351.
- Do I need a colonoscopy? new study on colon cancer screening effectiveness. (2022) NBCNews.com. NBCUniversal News Group. Available at: https://www.nbcnews.com/health/health-news/need-colonoscopy-new-study-colon-cancer-screening-effectiveness-rcna51515 (Accessed: November 1, 2022).
- Levi, F., La Vecchia, C., Randimbison, L., Te, V.C. and Franceschi, S., 1991. Patterns of large bowel cancer by subsite, age, sex and marital status. Tumori Journal, 77(3), pp.246-251.
- Cappell, M.S., 2005. The pathophysiology, clinical presentation, and diagnosis of colon cancer and adenomatous polyps. Medical Clinics, 89(1), pp.1-42.
- Cappell, M.S., 2007. From colonic polyps to colon cancer: pathophysiology, clinical presentation, screening and colonoscopic therapy. Minerva gastroenterologica e dietologica, 53(4), pp.351-373.
- Colorectal cancer: Screening (2019) Home page. US Preventive Services Taskforce. Available at: https://uspreventiveservicestaskforce.org/uspstf/document/final-research-plan/colorectal-cancer-screening (Accessed: November 1, 2022).
- Geboes, K. and Vantrappen, G., 1975. The value of colonoscopy in the diagnosis of Crohn’s disease. Gastrointestinal endoscopy, 22(1), pp.18-23.
- Shanahan, F., Weinstein, W.M. and Bernstein, C.N., 1994. Are we telling patients the truth about surveillance colonoscopy in ulcerative colitis?. The Lancet, 343(8889), pp.71-74.
Colorectal cancer guideline: How often to have screening tests (no date) American Cancer Society. Available at: https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html (Accessed: November 1, 2022).
- Colorectal cancer statistics: How common is colorectal cancer? (no date) American Cancer Society. Available at: https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html (Accessed: November 1, 2022).
- Sonnenberg, A., Delco, F. and Inadomi, J.M., 2000. Cost-effectiveness of colonoscopy in screening for colorectal cancer. Annals of internal medicine, 133(8), pp.573-584.
- Shahedi, K., Fuller, G., Bolus, R., Cohen, E., Vu, M., Shah, R., Agarwal, N., Kaneshiro, M., Atia, M., Sheen, V. and Kurzbard, N., 2013. Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy. Clinical gastroenterology and hepatology, 11(12), pp.1609-1613.
- Gyde, S., 1990. Screening for colorectal cancer in ulcerative colitis: dubious benefits and high costs. Gut, 31(10), p.1089.
- Sanchez, W., Harewood, G.C. and Petersen, B.T., 2004. Evaluation of polyp detection in relation to procedure time of screening or surveillance colonoscopy. Official journal of the American College of Gastroenterology| ACG, 99(10), pp.1941-1945.
- Stevens, T. and Burke, C.A., 2003. Colonoscopy screening in the elderly: when to stop?. The American journal of gastroenterology, 98(8), pp.1881-1885.
- Gatto, N.M., Frucht, H., Sundararajan, V., Jacobson, J.S., Grann, V.R. and Neugut, A.I., 2003. Risk of perforation after colonoscopy and sigmoidoscopy: a population-based study. Journal of the National Cancer Institute, 95(3), pp.230-236.