Colorectal cancer is one of the most preventable cancers — because screening can find and remove precancerous polyps before they ever become cancer. The catch is that early colorectal cancer usually has no symptoms, so screening is about catching problems before you would ever notice them.
The current starting age is 45
For adults at average risk, major guidelines now recommend beginning colorectal cancer screening at age 45 — lowered from 50 in recent years as more cases appeared in younger adults. Screening generally continues through age 75, with decisions after that made individually with your doctor.
You may need to start earlier
Talk to a gastroenterologist about screening before 45 if you have any of these risk factors:
- A parent, sibling, or child who had colorectal cancer or advanced polyps
- A personal history of inflammatory bowel disease (Crohn's disease or ulcerative colitis)
- A known inherited syndrome such as Lynch syndrome or familial adenomatous polyposis
- Symptoms like rectal bleeding, a lasting change in bowel habits, or unexplained iron-deficiency anemia — these warrant evaluation at any age, not a routine screening wait
What a colonoscopy actually involves
A colonoscopy is a same-day outpatient procedure. You will do a bowel-cleansing prep the day before, and the exam itself is done under sedation, so most people feel nothing and remember little. If a polyp is found, it can usually be removed during the same procedure — which is why colonoscopy is both a screening test and a preventive treatment. Plan for someone to drive you home afterward.
Why colonoscopy is the thorough option
There are several screening methods, including stool-based tests. Those are reasonable options for some people, but any positive stool test still requires a follow-up colonoscopy. Colonoscopy examines the entire colon directly and allows polyp removal in the same visit.
If you are 45 or older, or have any of the risk factors above, this is worth a conversation. Call AGI Gastroenterology at (718) 435-3489 to ask whether it is time for your first screening.