Colonoscopy. When you hear that word, is your reflex to clinch? You aren’t alone. The fear of the unknown, the hassle of the prep diet and bowel prep, and the thought of taking the “twilight medication” while having the procedure all sound scary. However, there is more than one option when it comes to colonoscopy screenings. Read on to find out what changes were made to colonoscopy screening guidelines.

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Colonoscopy Screening Updates

The new recommendations state that individuals with an average risk should begin screening at age 45. Individuals who are healthy (and expected to live more than 10 years) should have regular colonoscopy screenings through the age of 75. Between the ages of 76 and 84 — a discussion with a medical provider, a review of personal health, and previous screening results will determine the need for regular colonoscopy screening. Over the age of 85, there is no longer a need for colonoscopy screenings.

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Why the changes?

Changes in screening guidelines are not taken lightly. It takes years of research and reviews of records, statistics, and reports. In 2017, a study published in the Journal of National Cancer Institute revealed that 500,000 individuals were diagnosed with colorectal cancer between 1974 and 2013. This is about a 1% increase from previous studies. While not a huge increase, there is a concern for younger individuals who may not even consider colorectal cancer, and therefore not seek medical evaluation for years — even after problematic symptoms begin.

What increases your risk?

When discussing your health with a medical provider, you will be asked whether you have any family members with a history of colorectal cancer and if they — or you — have previously experienced colon polyps. A personal history of inflammation of the colon caused by conditions like Ulcerative colitis or Crohn’s disease may increase one’s risk. Previous treatment for an abdominal condition may also increase risk. Discuss any concerns you may have with your medical provider about your possible risk for colorectal cancer.

Types of Testing

There are two types of testing: visual testing and stool-based testing. Visual testing is the most common and includes a traditional colonoscopy, CT colonoscopy (virtual imaging through a CT scan), and a sigmoidoscopy. The good news is—if your traditional colonoscopy comes back negative, you won’t need another for 10 years. A CT colonoscopy and a sigmoidoscopy should be repeated within 5 years.

The second type of testing is a stool-based test, which can be done at home or in the office. Stool-based testing is very sensitive, as there are many positives for red food dye and it does not miss blood in the stool — which is what it’s testing for. The fecal immunochemical test (FIT) and the sensitive guaiac-based fecal occult blood test (gFOBT) need to be tested every year, whereas the stool DNA test (MT-sDNA) is recommended every 3 years.

Insurance dictates which tests are covered. Your medical provider should be able to tell you what is covered through your insurance.

taking the scary out of colonoscopy

Concerning Signs and Symptoms

If any of the following occur, contact your medical provider:

  • A change in bowel habits — diarrhea, constipation, or narrowing of the stool — that lasts for more than a few days
  • Feeling like you need to have a bowel movement that is not relieved by doing so
  • Rectal bleeding
  • Dark stools or blood in the stool
  • Cramping or abdominal pain
  • Weakness and/or fatigue
  • Unintended weight loss

What’s next?

There are several things you can do to lower your risk of colorectal cancer. American Cancer Society recommends avoiding tobacco and limiting alcohol to two drinks a day for men and one drink a day for women. Keep your bowels happy and healthy by eating grains, fruits, and vegetables. Avoid processed meats and red meats. Keeping a consistent exercise routine also aides in decreasing your risk.

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taking the scary out of colonoscopy screening


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