When should you get a colonoscopy and how often?

Happy mature middle-aged couple confirming that they booked their colonoscopy exam on a tablet during breakfast.

06/08/2025

When should you get a colonoscopy? Stay updated on colorectal cancer screenings and guidelines so you can be proactive about your digestive health.

By Suma Magge, MD, Gastroenterology, Nuvance Health Medical Practice Gastroenterology Norwalk, part of Northwell Health

Knowing when you should have your first colonoscopy is a crucial step for maintaining your digestive health and preventing colorectal cancer. A colonoscopy is an effective screening method that allows doctors to spot and remove a growth or bump called a polyp, before it turns cancerous. Current colonoscopy age recommendations suggest starting regular screenings at age 45 for those at average risk but personal risk factors may require earlier intervention.

Learn when you should first get a colonoscopy, how frequently you should have them and what factors influence these decisions.

Understanding what a colonoscopy is

A colonoscopy is a procedure that enables a doctor called a gastroenterologist to examine the inner lining of your large intestine using a flexible, lighted tube called a colonoscope. This vital screening tool helps your doctor detect abnormalities such as polyps and early signs of colorectal cancer.

Typically recommended for people over the age of 45, colonoscopy age recommendations can vary based on family history and other risk factors. Understanding when you should have your first colonoscopy and how often colonoscopies are needed is key to proactive health management.

Learn more about colonoscopies in this video: See what it’s like to get a colonoscopy screening

A colonoscopy exam involves inserting the colonoscope through the rectum into the colon. Proper preparation, including dietary adjustments and bowel cleansing, ensures a successful examination. Sedation is provided for comfort and the procedure usually lasts 30 to 45 minutes. Minimal discomfort is expected and you'll need someone to drive you home afterward. Your doctor will discuss the findings and any necessary follow-up care if polyps are discovered.

Recommended age for first colonoscopy

Colonoscopy age recommendations advocate starting screenings at age 45 for people with an average-risk of colorectal cancer due to increasing colorectal cancer rates among younger populations. Understanding when you should have your first colonoscopy is important, especially if you have a family history of colorectal cancer or genetic conditions that may prompt earlier screenings. Factors such as personal medical history, lifestyle choices and specific risk factors play a role in determining the best timing for your first colonoscopy.

Early detection is vital for effective treatment of colorectal cancer. Regular screenings allow for the removal of precancerous polyps, reducing the risk of cancer development. Discuss your individual risk factors with your doctor to determine when you should have your first colonoscopy and how often colonoscopies are needed based on your health profile.

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High-risk groups for colorectal cancer

Identifying high-risk groups is essential for timely colorectal cancer screenings. High-risk individuals include those with a family history of colorectal cancer, inflammatory bowel diseases like ulcerative colitis or Crohn's disease and certain genetic conditions. Various high-risk factors contribute to the likelihood of developing colorectal cancer.

Age is a key factor, with most diagnoses occurring in people over the age of 50 — although more young people are getting diagnosed with colorectal cancer. Additional risk factors include personal or family history of colorectal cancer or polyps, certain genetic factors, a diet high in processed meats, obesity, smoking and a lack of physical activity. For these groups, colonoscopy age recommendations may suggest starting screenings earlier than the general population, sometimes before age 45.

Learn more about inflammatory bowel disease

Consult with your gastroenterologist to establish a personalized colonoscopy screening plan. Understanding when you should have your first colonoscopy based on your risk factors is crucial. Lifestyle choices, family history and diet also influence your screening timeline. Awareness and regular check-ups empower you to make informed decisions about when to begin screenings and how often colonoscopies are necessary for you.

Colonoscopy screening considerations beyond age 75

As you age, conversations about colonoscopy screenings become more complex, particularly for those over 75. While age alone isn't the sole factor, overall health and life expectancy play significant roles in deciding when you should have your first colonoscopy in older adulthood. Colonoscopy age recommendations for this group rely on assessing individual health goals and potential risks associated with the procedure.

Discussing screening options with your doctor ensures that decisions align with your personal health needs. Evaluating the benefits and risks of colonoscopy screenings at this age is crucial, especially for those with multiple health conditions. Personalized recommendations help balance the advantages of early detection with potential procedural risks which are low.

Detecting colorectal cancer early is crucial. When identified in its initial stages, the five-year survival rate is about 90%. Regular colonoscopy screenings can help your doctor remove precancerous polyps. Knowing your risk factors and adhering to recommended screening schedules is vital for effective colorectal cancer prevention.

How often do I need a colonoscopy screening?

Screening for colorectal cancer is essential for early detection. The U.S. Preventive Services Task Force recommends people at average risk of colorectal cancer begin screenings at age 45. This proactive strategy aims to uncover potential issues before they escalate.

The frequency of colonoscopy screenings is determined by your individual risk levels. For example, if you are at an average risk, a colonoscopy is generally only recommended every 10 years. However, if polyps are discovered during your screening or you have a family history of colorectal cancer, your doctor may recommend you undergo colonoscopies more frequently.

High-risk individuals, such as those with a family history of colorectal cancer or specific genetic conditions, may need to start screening earlier — typically at age 40 or 10 years prior to the earliest diagnosis in their family. For these patients, colonoscopy may be suggested every five years or even more frequently, depending on their overall condition.

The bottom line: Regular colorectal cancer screenings are essential as they can identify colorectal cancer at its earliest and most treatable stages. Colonoscopies enable your doctor to detect and remove precancerous polyps before they progress into cancer, significantly lowering your risk of developing the disease.

Considering a colonoscopy? Book an appointment with a gastroenterologist.