We get it. No one really looks forward to a colonoscopy. 

Mildly inconvenient though it may be, a colonoscopy can literally save your life–or the life of a family member–by detecting colon cancer early. Recently, the American Cancer Society updated colonoscopy screen guidelines to lower the recommended age from 50 to 45.

That means if you or your partner is 45 or under, an annual colonoscopy might have just become a life-saving diagnostic.

When Did Colonoscopy Age Change to 45?

A colonoscopy is designed to detect a type of cancer known as colorectal cancer. As the name implies, colorectal cancer usually begins in the colon or rectum. Usually, growths begin as symptomless polyps, and they’re easily detectable by a colonoscopy. If these polyps are removed quickly, the cancer doesn’t really have a chance to get going.

That means early detection is essential in effectively treating colorectal cancer. And, in general, colonoscopies have been very successful in doing just that. 

However, in 2016, researchers began to notice a significant uptick in the number of advanced colorectal cancers detected in people around the age of 50. The screening was working, but it was detecting the cancer too late. As a result, the U.S. Preventive Services Task Force recommended changing the colonoscopy screening age to 45–a change that took effect in 2021. 

Cause Unknown

Researchers have not been able to identify the root cause behind the uptick in colorectal cancers in younger patients. And this is concerning, because this particular form of cancer can be quite aggressive and difficult to treat in later stages. 

You may have a parent or a partner who’s hesitant to undergo a colonoscopy because they feel they are “too young” to get colorectal cancer. It can be helpful to note the urgency behind this changed guideline. 

Assessing Your Risk

When you think about how these new guidelines impact your or your family, it’s important to consider your risk factors. In general, if you have a normal level of risk, you should begin your colonoscopy screenings at age 45, as per these new recommendations. 

However, if you are at an increased risk for colorectal cancers, your primary care physician may recommend you begin undergoing an annual colonoscopy earlier. Some of those increased risk factors may include:

• Personal medical history that includes a previous colorectal cancer diagnosis or a previous detection of polyps.

• Inflammation of the large intestine: This could be caused by Crohn’s disease or other conditions that cause frequent inflammation.

• Family history: If you have a family history that includes colon cancer, your physician may recommend earlier or more frequent colonoscopies. 

• Diabetes: Diabetes can increase your risk for developing colon cancer, so your primary care physician may recommend earlier screenings.
• Lifestyle choices: Sometimes lifestyle choices can play a part, too. Too much time sitting or too much fat in your diet may increase your risks. It will be up to you and your physician to determine whether these risks warrant increased scrutiny.

It’s important to point out that researchers don’t yet know why rates of colorectal cancer are increasing. Specific risk factors for the presentation in younger individuals have not yet been identified.

What Happens During Your First Colonoscopy

If you’ve got a reluctant family member who isn’t quite ready to call the doctor, it might be useful to know what happens during your first colonoscopy exam. The procedure itself typically takes somewhere between 30-60 minutes, and patients will be given a sedative (often, along with anesthesia or pain medication). In many cases, you’ll be completely sedated during the procedure.

Once the sedation has taken place, the physician will insert a long, thin tube into your rectum. This tube has a camera on the end of it, which means it will be able to detect any polyps or other issues. In many cases, suspect tissue can be removed or biopsies performed during your colonoscopy.

Once the procedure is complete and the sedation wears off a bit, you’ll be able to return home. In most cases, you’ll want someone there to drive you, due to the impact of the sedation. Discomfort is typically minimal, and you can always talk to your doctor about ways to increase your comfort level.

When Should You Get Your First Colonoscopy?

If you’re over the age of 45 and you’ve never undergone a colonoscopy before, you should talk to your primary care physician about scheduling a screening. If you have a family member who you know should be screened but who hasn’t made an appointment, there are some things you can do to help gently encourage them:

• Find helpful and straightforward resources about colonoscopy on the internet and email those resources to your family member.
• Connect your family member to someone who has recently undergone a colonoscopy. People tend to trust first-hand accounts, so this can be extremely helpful.
• Schedule a colonoscopy for yourself (assuming you’re over 45 and your physician approves). In this way, you can lead by example.
• Celebrate! Once your family member’s colonoscopy is all finished and they’re fully recovered, go out for ice cream!

At most, a colonoscopy could cause a couple of days of mild discomfort. But that discomfort is worth it–you will either detect colorectal cancer earlier in the process or experience the relief of knowing you’re free from colorectal cancer. Regular screenings will be needed to make sure you can catch colorectal cancer as early as possible should it develop in the future.

We expect this new change in the recommendation to save countless lives over the years. One of them could be yours.

If you have questions about your colonoscopy, including about what happens during the procedure, contact your physician to ask these questions.