At what age should I get a colonoscopy?

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Last updated: June 13, 2025View editorial policy

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From the Guidelines

The recommended age to get your first colonoscopy is 45 for people at average risk of colorectal cancer. This is based on the most recent guidelines from the American College of Gastroenterology and the US Multi-Society Task Force on Colorectal Cancer, as reported in the study by 1. If you have a family history of colorectal cancer, personal history of inflammatory bowel disease, genetic syndromes like Lynch syndrome, or previous polyps, you should start screening earlier, typically at age 40 or even younger.

Key Considerations for Screening

  • The American Cancer Society recommends screening for colorectal cancer beginning at age 45 for people at average risk, as stated in the study by 1.
  • The US Preventive Services Task Force recommends screening for adults between ages 50 and 75, but also suggests starting screening at age 45 for those at increased risk, as mentioned in the study by 1.
  • The procedure requires preparation the day before, which includes a clear liquid diet and drinking a bowel-cleansing solution.
  • Colonoscopies are important because they can detect and remove precancerous polyps before they develop into cancer, making this screening test both diagnostic and preventive.

Follow-up Screenings

  • Follow-up colonoscopies are typically recommended every 10 years if no abnormalities are found, but your doctor may recommend more frequent screenings based on your results, as suggested by the study by 1.
  • The procedure itself takes about 30-60 minutes, is performed under sedation, and is generally well-tolerated by most patients.
  • It is essential to discuss your individual risk factors and screening options with your doctor to determine the best approach for your specific situation, as emphasized in the study by 1.

From the Research

Age Recommendations for Colonoscopy

The recommended age for colonoscopy varies depending on the individual's risk level.

  • For average-risk individuals, most guidelines recommend screening between 45 and 75 years 2.
  • For high-risk individuals, such as those with a positive family history of colorectal cancer or advanced colorectal polyp, screening should begin at age 40 2.

Comparison of Age Groups

Studies have compared the prevalence of colorectal neoplasia in different age groups.

  • One study found that individuals aged 40-49 have a lower but measurable risk of colorectal neoplasia compared to those aged 50-59 3.
  • Another study found that the prevalence of total adenomas was similar in individuals ages 40-49 and in those 50-59 years, although the prevalence of advanced neoplasia in the 50-59 years age group may be higher than that in the 40-49 years age group 4.

Screening Guidelines

The USPSTF recommends beginning colorectal cancer screening at age 50 3.

  • However, some studies suggest that screening may be beneficial for individuals under 50, particularly those with a family history of colorectal cancer 2, 3.
  • For individuals over 75, the risk-benefit ratio of ongoing screening begins to shift, and firm age cutoffs are not sufficient to guide these decisions 5.

Screening Intervals

The recommended screening intervals for colonoscopy vary depending on the individual's risk level.

  • For average-risk individuals, colonoscopy is recommended every 10 years 2, 6.
  • For high-risk individuals, colonoscopy is recommended every 5-10 years 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Colorectal cancer screening guidelines for average-risk and high-risk individuals: A systematic review.

Romanian journal of internal medicine = Revue roumaine de medecine interne, 2024

Research

Colorectal Cancer Screening in the Elderly.

Clinics in geriatric medicine, 2021

Research

Colorectal Cancer Screening and Prevention.

American family physician, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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