Is it time for me to get a colonoscopy?

Although colorectal cancer, the third most common cancer and cancer mortality in America, has declined overall in the 50+ age group, death rates are rising in people younger than 50 according to the American Cancer Society. The good news is that colon cancer is treatable and beatable if you get regular screenings for potential colon polyps (abnormal growth of tissue projecting from a mucous membrane).

A colonoscopy is one of several tests used to screen for colorectal cancer. In this commonly performed procedure, a doctor inserts a long thin, flexible tube with a light at the end into the patient’s rectum and throughout the entire colon. With CT colonography (”virtual colonoscopy”), images of the large intestine are taken using computerized tomography (CT), using software that is able to create an animated, three-dimensional view of the inside of the large intestine. If a colon polyp is discovered on a CT colonography then a colonoscopy is required in order to remove the polyp.

Your screening needs depend on your risk for colon cancer. If you are at average risk (no family history of colon cancer or colon polyps), you should get screened every 10 years (at least). People with a family history of polyps or colorectal cancer need to be screened starting at an earlier age and more often. Those with inflammatory bowel disease, or a hereditary syndrome such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colorectal cancer syndrome (HNPCC, Lynch syndrome) should also have colonoscopy performed as often as every 1-2 years.

In 2008, several agencies issued guidelines on the various strategies for colorectal cancer screening and how often they should be performed (see chart below). As always, seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition.