Very few commonly done procedures invoke the anxiety that a colonoscopy produces, yet a colonoscopy should be performed regularly in most patients in order to detect and possibly prevent the third most common cancer in men and women.
The American Cancer Society recommends that men and women at average risk* should be screened for colorectal cancer starting at age 45. Although there are other tests that can screen for cancer, a colonoscopy is the only screening test that also can prevent cancer from developing. If you are at high risk of developing colorectal cancer, your doctor may recommend that you have a colonoscopy starting at a younger age.
*For screening, people are considered to be at average risk if they do not have:
A personal history of colorectal cancer or certain types of polyps
A family history of colorectal cancer
A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)
A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer
People who are in good health and with a life expectancy of more than 10 years should continue regular colorectal cancer screening through the age of 75.
For people ages 76 through 85, the decision to be screened should be based on a person’s preferences, life expectancy, overall health, and prior screening history.
It is recommended that people over 85 should no longer get colorectal cancer screening, but I believe that in specific circumstances it may be prudent to look for cancer in these patients.