General Health

How Often Should You Get a Colonoscopy? A Quick Guide

August 18, 2022

While the thought may make you squirm, the reality is that a colonoscopy can be life-saving, catching colon cancer or colon cancer risks at an early stage when it's much more manageable to treat. 

And yes, prostate exams are frequently confused with a colonoscopy. These completely different procedures serve two very different functions. 

  • A colonoscopy provides information on the inside of the digestive tract and is useful in catching colon cancer early.
  • A prostate exam assesses prostate health, which is important for sexual and urinary function, like providing strong ejaculation and consistent bladder emptying.

While both involve a rectal exam, they provide dramatically different sets of information. Though these procedures are no one's favorite doctor visit, they can provide critical and lifesaving information 

Below is a closer look at what a colonoscopy is, why it's performed, as well as how often you may need one. 

A doctor holding a scope for a colonoscopy

What Is a Colonoscopy?

A colonoscopy is a procedure that involves the use of a camera probe to examine your bowels. With a visual examination of your bowels, health care providers can tell in more detail how well the bowel is functioning, if there are any abnormal growths, and whether or not further medical intervention might be necessary.

The primary goal with a colonoscopy is to catch colon cancer early, when it's easily treated.

Below is a closer look at everything a colonoscopy entails, as well as what to expect when it comes to the procedure. 

Colonoscopy Prep

A colonoscopy requires some forethought because, under normal circumstances, you're eating solid food which contributes to solid waste in your bowel.

Prep for a colonoscopy generally requires an all-liquid diet, the administration of laxatives, or the use of an enema to maintain a clear lower digestive tract when it comes time for the procedure.

None of these are particularly enjoyable, but they all allow for a clearer view of your insides and allow for the colonoscopy probe to be maneuvered throughout the colon. 

If this prep is not done sufficiently, it can cause the physician to only be able to observe small or inadequate sections of the bowel and may require you to go through the entire procedure and prep again.

Procedure

While the thought of a four-foot-long colonoscope going into your bowel may make you squeamish, the procedure isn't as uncomfortable as you might guess. The procedure starts with the administration of a muscle relaxant. Once this oral medication has gone into effect, you'll be positioned on your left side with your knees drawn up towards your chest. Some procedures will have you on a sedative, where you’ll basically sleep for the entirety of the procedure.

The colonoscope (which is about the width of a single finger) is inserted and maneuvered through the bowel with a live feed provided on a screen in the procedure room. The provider will monitor the screen throughout the procedure and look for abnormalities such as growths known as polyps, abnormal pockets known as diverticula, and more. 

While this procedure may seem more invasive than others, one of its main benefits is that if abnormal tissue is observed, it can be biopsied on the spot. Many colonoscopes have the ability to harvest a sample that can be brought to a lab to determine if it's cancerous. 

Colonoscopy Results

A number of key results can be obtained from a colonoscopy.

The most common reason for a colonoscopy is to screen for colon cancer. After a successful procedure, your healthcare team can inform you whether or not there is any visual evidence of colorectal cancer. 

In addition to providing clarity of cancer status, a colonoscopy can reveal other intestinal issues such as intestinal bleeding, inflammation, diverticulitis, and polyps. As described previously, polyps can be removed during a colonoscopy, but their presence can be indicative of an increased chance of colorectal cancer and are included in your colonoscopy results. 

If everything checks out and you're at no increased risk for colorectal cancer, this test is typically repeated every 10 years.

If there is evidence of polyps or pre-cancers, a follow-up may be necessary sooner. 

Colonoscopy Screening Recommendations

The current recommendation from the American Cancer Society is to start colon cancer screening after the age of 45 if you're at average risk, and every ten years after that. 

After 75, your doctor will help decide how frequently an exam is necessary.

Unlike a prostate exam, colon screenings are an important procedure for both men and women. 

The ACS recommendation encompasses the vast majority of people, but there are factors that play a role in how frequent and at what age you may need to begin your screenings. 

Factors such as family history, the previous discovery of polyps, previous cancers, and other intestinal issues can lead to recommendations being shifted to earlier in life and with increased frequency. 

Other Colon Screenings

While colonoscopies have been the long-standing gold standard for colorectal cancer screening, other options are available to help screen for colorectal cancer. 

These include fecal tests, imaging, and more. While these are often more convenient than a colonoscopy, providers are unable to provide real-time biopsies, and they may not be as accurate as a colonoscopy. 

The Takeaway

A colonoscopy is intended to identify and diagnose colorectal cancer and pre-cancerous risk factors. The test is recommended for those 45 or older, and at a minimum should be performed every 10 years. 

These recommendations can change based upon family or historical risk factors, and your doctor will help determine the right timeline for you and your cancer screenings. 

As we age, cancer screenings and annual checkups are some of the most important preventative health actions we can take. While uncomfortable, a colonoscopy could save and extend your life.

Sources

Colonoscopy | Mayo Clinic

Colorectal Cancer Guideline | How Often to Have Screening Tests | ACS

Colorectal Cancer Risk Factors | Hereditary Colorectal Risk Factors | ACS