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Dr QM Leong
Dr QM Leong

How Often Should You Have A Colonoscopy? 4 Key Factors

Understanding one’s health and taking preventive measures is integral to modern life. A significant concern is how often you should have a colonoscopy. A colonoscopy, which involves examining the colon and rectum for abnormalities, plays a pivotal role in the early detection of colorectal cancers and other digestive system anomalies.

It’s not just a matter of routine; the frequency of how often should you have a colonoscopy hinges on various factors. This could be age and medical history to specific symptoms and risks. 

This article takes you through the guidelines, underscoring the importance of timely screenings and shedding light on when and why you might need to schedule your next colonoscopy. 


How Often Should You Have A Colonoscopy?

The American Cancer Society advises commencing colonoscopy screenings from the age of 45, followed by routine checks every 10 years, dependingon multiple considerations. Yet, certain protocols propose initiating these from the age of 50.

Suppose you don’t possess specific risk indicators like a familial lineage of colon cancer or conditions like ulcerative colitis or Crohn’s disease. In that case, you’re typically deemed to have an ordinary risk level.

While colonoscopy screenings remain the primary method for colorectal cancer screening, alternative screening tests,such as stool tests and CT scans are available. If these screening tests yield a positive or negative result, getting a follow-up colonoscopy to inspect the entire colon and confirm the results might be necessary.

Factors That Put You Into The High-Risk Group

Understanding one’s risk for colorectal cancer is essential for early detection and effective prevention. Various risk factors influence the likelihood of an individual developing colorectal cancer, including:


1. Family History Of Colorectal Cancer

If you have a first-degree relative (parent, sibling, or child) who had colorectal cancer or polyps before age 60 or two or more first-degree family members who had them at any age,this could indicate you are at a higher risk of developing the disease. 

Such colon cancer risk factors require a more proactive approach to screening. In this scenario, you should get a colonoscopy at age 40 or 10 years before the youngest relative’s diagnosis, whichever is earlier. Furthermore, you should also have them more frequently, usually every five years.


2. Personal History Of Polyps Or Colorectal Cancer

Your history is vital in gauging your recurrent colon and rectal cancer risk factors. If you’ve had colorectal cancer or colon polyps in the past, the odds of developing colorectal cancer again heighten. This risk emphasises the importance of more frequent follow-up colonoscopies to monitor changes in the digestive tract and remove new polyps.

The timing and frequency of these screenings depend on the number, size, type, and location of your previous polyps and the quality of your colonoscopy. Discuss this with your primary care physician, and create a schedule for screenings that you should strictly adhere to.


3. History Of Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) encompasses persistent ailments leading to inflammation within the digestive system, including ulcerative colitis and Crohn’s disease. Those with IBD face a heightened likelihood of developing colorectal cancer as the years progress. 

If diagnosed with IBD, it’s advisable to commence colonoscopy screenings eight years post-diagnosis and every 1 to 3 years, based on your specific risk elements and results from past screenings.


4. Lifestyle 

Some lifestyle factors can increase or decrease your risk of colorectal cancer. For example, being overweight or obese, physically inactive, smoking tobacco, drinking alcohol, eating a diet high in red and processed meats, and having low vitamin D levels can increase your risk. 

On the other hand, eating a diet rich in fruits, vegetables, and whole grains, exercising regularly, maintaining a healthy weight, quitting smoking, limiting alcohol intake, and taking vitamin D supplements can lower your risk. While these factors do not directly affect how often you should get a colonoscopy, they can affect your overall health and well-being.

Results That Dictate Your Next Appointment

The outcomes of your colonoscopy screening are integral in determining when your next colonoscopy will be due. Once the screening test is complete, your doctor will carefully assess the results and, based on the findings, will recommend the best course of action. Generally, there are three potential outcomes:

Negative Result

If the colonoscopy does not detect any issues, the result is labelled as negative. This signifies the absence of polyps, cancer, or any inflammatory bowel disease. A negative outcome means you’ve been spared from the risk of developing any immediate concerns.

Therefore, it’s safe to stick to the general guidelines: undergoing a colon cancer screening once every ten years. However, more frequent colorectal screening might be necessary if you possess other risk factors.

Positive Result

A colonoscopy is deemed positive when the doctor detects and ensures polyps are removed or any other abnormal tissue within the colon. Such a finding might hint at a precancerous condition or a cancer diagnosis, mandating further analysis and possible treatments.

In the wake of a positive result, you’ll likely need a follow-up colonoscopy sooner than the typical 10-year gap. This depends on several attributes of the discovered polyps or abnormal tissues, such as their number, size, type, and exact location.

Incomplete Result

An incomplete colonoscopy arises when the doctor cannot inspect the entire colon. This could result from inadequate bowel preparation, technical obstacles, or even complications during the procedure. This might leave certain regions of the large intestine unchecked and potentially harbour health concerns. 

Should you encounter an incomplete result, a repeat of the colonoscopy becomes imperative. Typically, this follow-up colonoscopy screening should be scheduled in a brief window, often within the next six months, to ensure overall health.

Best Time Of Day For A Colonoscopy

According to a study published in the Annals of Gastroenterology, colonoscopies performed in the afternoon have shown lower Adenoma Detection Rates (DTR). This measures the quality of the colonoscopy performed and should be at least 25% for men and 15% for women.

If you have a choice, getting a colonoscopy in the morning rather than in the afternoon may be better. 

This may be because bowel preparation is more effective closer to the procedure time. However, this does not mean that afternoon colonoscopies are useless or unsafe. The difference in detection rates between morning and afternoon colonoscopies is small and may not affect your overall outcome. 

The most important thing is getting a high-quality colonoscopy from an experienced, skilled colorectal surgeon who follows the best practices and guidelines.


Conclusion On How Often You Should Have A Colonoscopy

Understanding how often you should have a colonoscopy is imperative to maintain optimal colon health and detect potential health concerns early. The frequency of this important test will vary greatly, influenced by individual risk factors, personal and family health histories, and previous results. Remain proactive, regularly consult with your healthcare professional, and be vigilant about any changes in your health. This will lead to timely interventions and peace of mind.

Remember, it’s not just about undergoing a procedure; it’s about taking charge of your health, being well-informed, and making decisions that safeguard your future. Your health is invaluable, and a colonoscopy, when appropriate, is a small step with profound implications.


Frequently Asked Questions On How Often You Should Have A Colonoscopy

Why Is Age 45 Or 50 Recommended For The First Colonoscopy?

The recommendation for the initial colonoscopy at age 45 or 50 is based on studies indicating that the risk of developing colorectal cancer begins to increase significantly from these ages. Screening at this age ensures early detection of potential issues for those at average risk.

Are There Alternatives To A Traditional Colonoscopy?

There are alternative colorectal screening methods, such as stool tests, flexible sigmoidoscopy, and virtual colonoscopy. However, suppose any of these tests yield a positive result. In that case, a follow-up colonoscopy is typically recommended to confirm findings and potentially remove any polyps.

Is There An Age At Which Colonoscopies Are No Longer Recommended?

Colonoscopies are usually not recommended routinely for individuals over age 75, but decisions should be individualised based on health status and life expectancy.

Is The Colonoscopy Procedure Painful?

Most patients are sedated during the procedure and do not feel pain. Some might experience mild discomfort or pressure, but severe pain is uncommon.