The Recommended Age For A Colonoscopy (Just Lowered by ACS)
Are you up-to-date on current colonoscopy guidelines?
In the past, 50 was the magic number for colorectal cancer screening.
However, in a review of decades worth of statistics, the American Cancer Society now recommends most adults consider colorectal screening as early as 45-years old.
Why Did The Recommended Age For Colonoscopy Screening Change?
There are several factors that determine which health screenings are required at what age and for whom.
Risk factors are one of these, including both genetic factors (what you inherit from your parents and ancestors via DNA) and lifestyle factors (the day-to-day choices you make that affect physical wellbeing), as well as existing or historical health conditions.
Prior to the American Cancer Society’s 2018 update, colorectal specialists considered Age 50 the targeted age bracket for adults to get screened, with a few exceptions.
African Americans and other ethnicities more prone to colon cancer
African Americans have higher rates of colon cancer as well as higher mortality rates as a result of colon cancer. Therefore, in 2012, both the American College of Gastroenterology (ACG) and the American College of Physicians (ACP) recommended African Americans start screenings years earlier.
The ACG recommends African Americans begin colorectal screening of some type at age 45 while the ACP recommends African Americans err on the side of conservative and seek screening at age 40.
These screenings include fecal tests (FIT, gFOBT, or MT-sDNA) every one- to three-years, and visual tests, like a sigmoidoscopy or colonoscopy, every five- to 10-years, depending on the individual’s family and personal medical history.
These guidelines are in direct response to statistics that indicate earlier detection and diagnosis in the African American population can notably decrease mortality rates for those who have colon cancer.
Jews of Eastern European descent (Ashkenazi Jews) are the second-most likely ethnicity to get colon cancer.
Those with close family members who’ve had colon cancer
If someone closely related to you such as a parent or sibling has had colorectal cancer, your physician will also recommend screening at age 45. Again, early detection has been the key to reducing mortality rates.
Because most colorectal cancers are asymptomatic until later in their development, screening and diagnostic testing earlier on allows medical professionals to remove cancerous tissue and/or begin cancer treatments that are more likely to be effective while the cancer is in its earliest stages and before it has metastasized.
Existing conditions that put you at risk for colon cancer
Certain medical conditions put you into the higher-risk bracket.
These include conditions such as:
- Polyps in the colon or rectum, even if they were benign
- A history or current diagnosis of irritable bowel disease (IBD)
- Other existing GI disorders such as Crohn’s disease, diverticulitis, ulcerative colitis, and other inflammatory bowel diseases.
In instances such as these, colonoscopies are typically recommended every two to three years and are considered preventative medicine.
Further Data Encourages Change In Age For Colonoscopy
The newest guidelines recommending 45-years old, rather than 50-years old, as the ideal time to begin screening for colon cancer are based on continued research. However, the medical establishment has had mixed reviews about the new guidelines.
An article in the Journal of Gastroenterology and Hepatology, titled, Lowering the Starting Age for Colorectal Cancer Screening to 45 Years, researchers state:
“In the big picture, whether to begin screening at age 45 or 50 seems relatively unimportant when compared with using individual patient risk for advanced neoplasia in practical, feasible models that are implemented to achieve substantial adherence to efficient and cost-effective screening.”
So, while some statistical analysis indicates that earlier screenings are advantageous, other findings are not so clear. With that in mind, most physicians agree that personalized attention to family and personal medical history, as well as other colorectal cancer indicators, should determine which age is the right age for patients to have their first colonoscopy screening.
It is also important to note that medical insurance companies may not cover colorectal screening until age 50-years or older at this point unless you are considered in the higher-risk bracket for getting colon cancer or your personal medical history requires it. It’s always best to contact your insurance carrier and verify whether or not your colonoscopy will be covered before age 50.
Why Not Get Screened at Age 45?
The reality is that colon cancer can be present without any symptoms; when it’s it caught early, it is highly treatable, but when it’s caught late it can be fatal.
If you are in one of the higher-risk brackets, it makes sense to speak to your physician about the American Cancer Society’s revised guidelines and whether or not you should get screened prior to age 50.
You may also want to consider screening earlier rather than later if you are at higher risk for developing colorectal cancer. That includes things like:
- An inherited risk via a father, mother, sibling or child with colon cancer
- A genetic risk (genetic testing is reasonably priced and often covered by insurance. These tests can be helpful in determining your risk for a variety of known diseases and cancers, including colon cancer).
- Lifestyle factors such as smoking, a sedentary lifestyle, poor diet, type 2 diabetes or heavy alcohol use
Understanding The Change In Recommended Age For Colonoscopy Screenings
Are any of these true for you?
Again, speak to your general physician, or CRS provider, and share your concerns. While the idea of a colonoscopy may not be appealing, millions of American adults will tell you it’s really not all that bad. Colonoscopy prep has come a long, and more gentle way and tens of thousands of people can honestly say that colonoscopies saved their lives.
Learn more about colonoscopy screenings in these helpful resources:
CRS offers routine colonoscopy screenings in our convenient and comfortable endoscopy suites. We even offer some appointments on Saturdays for those who just can’t seem to fit it in during the work week. Learn more or click to Schedule Your Colonoscopy Appointment (button).