US guidelines recommend that adults at average risk begin colorectal cancer screening at age 45, and colonoscopy is the only option that finds and removes precancerous polyps in a single procedure. Other tests exist, and the best one is the one you will actually complete. Colon cancer screening is one of the services highlighted by the Scottsdale practice behind DigestiveAZ.com, so this article explains the options and timing.
Key takeaways
- Average-risk adults should start screening at 45 and continue through 75.
- Family history, inflammatory bowel disease and some genetic conditions can mean starting earlier.
- Stool-based tests are done at home; a positive result needs a follow-up colonoscopy.
- New symptoms such as bleeding need evaluation, not screening.
Why the starting age is 45
For years, screening started at 50. In 2021 the US Preventive Services Task Force lowered the recommended starting age to 45 for adults at average risk, reflecting a rise in colorectal cancer among younger adults. The Task Force recommends screening through age 75, with decisions after that made individually.
Screening aims to catch problems before symptoms appear. Many colorectal cancers develop slowly from polyps over years, so finding and removing polyps early can prevent cancer altogether.
Screening also finds cancers at an earlier stage, when treatment is usually simpler and more effective. That is why reminders from your primary care provider matter, and why it is worth putting your screening date in your calendar once you have one. If you have moved recently or changed doctors, ask your new provider to check when you were last screened so nothing slips through the gaps.
Your screening options
| Test | How it works | Typical interval if normal |
|---|---|---|
| Colonoscopy | Camera exam of the whole colon; polyps removed during the procedure | Every 10 years |
| Stool test (FIT) | Home test for hidden blood in stool | Every year |
| Stool DNA test with FIT | Home test for blood and DNA markers | Every 1 to 3 years |
| CT colonography | Imaging of the colon | Every 5 years |
| Flexible sigmoidoscopy | Camera exam of the lower colon | Every 5 years, or 10 with yearly FIT |
If any test other than colonoscopy is abnormal, a follow-up colonoscopy is needed to find out why. The NIDDK colonoscopy guide explains what that procedure involves.
Who should start earlier
- People with a parent, sibling or child who had colorectal cancer or advanced polyps.
- People with long-standing ulcerative colitis or Crohn’s disease affecting the colon.
- People with certain inherited syndromes, such as Lynch syndrome.
- Anyone who has had polyps or colorectal cancer before.
If any of these apply, talk to your primary care provider or a gastroenterologist about when to start and how often to repeat screening. Our explainer on IBD vs IBS covers why inflammatory bowel disease changes the schedule.
Screening vs symptoms
Screening is for people without symptoms. If you have rectal bleeding, black stools, a lasting change in bowel habits, unexplained weight loss or anemia, you need a diagnostic evaluation instead, whatever your age. Do not wait for a routine screening date.
Taking the next step in Scottsdale
- Check your family history and any personal risk factors.
- Talk to your primary care provider about which test suits you.
- Check insurance coverage; our referrals and billing guide explains how screening and diagnostic procedures can be billed differently.
- If you choose colonoscopy, read our colonoscopy prep guide.
- Book with a gastroenterology practice.
The practice described on the DigestiveAZ.com overview page performs colonoscopy at its endoscopy center in Suite 117, and you can read about the related upper endoscopy procedure too. More procedure articles are in GI procedures, and further updates appear in the blog. To book with the team behind DigestiveAZ.com, call (480) 563-5757.
Overcoming common worries
Many people put off screening because of understandable worries. A few facts can help:
- “The prep is unpleasant.” Modern prep regimens are often split into two doses, which many people find easier, and practical tips make it more manageable.
- “I feel fine.” Screening is designed for people without symptoms, because early polyps and cancers usually cause none.
- “I’m worried about the procedure.” Colonoscopy is commonly done with sedation, and most people go home the same day.
- “I’m not sure about cost.” Many plans cover preventive screening; check with your insurer before booking.
If colonoscopy feels like too big a step right now, ask your clinician about a stool-based test. Completing a recommended test is far better than delaying screening altogether.
Talking to your family
Family history affects when relatives should start screening. If you have polyps removed or receive a diagnosis, let parents, siblings and adult children know so they can discuss their own timing with their doctors. A short family conversation can make a real difference.
Frequently asked questions
At what age should I get my first colonoscopy?
Adults at average risk are advised to begin colorectal cancer screening at 45. Colonoscopy is one of several options. If you have a family history, inflammatory bowel disease or other risk factors, you may need to start earlier, so ask your clinician for personal advice.
Is a stool test as good as a colonoscopy?
Stool tests are recommended screening options and are easy to do at home, but they need repeating more often, and a positive result requires a follow-up colonoscopy. Colonoscopy can find and remove polyps in one procedure. The best test is one you will complete on schedule.
How often do I need a colonoscopy if it is normal?
For many average-risk adults with a normal colonoscopy, the next screening is due in about 10 years. If polyps are found, or you have other risk factors, your gastroenterologist will recommend a shorter interval based on the findings and your history.
Should I get screened if I have symptoms?
No, symptoms call for a diagnostic evaluation rather than routine screening. Rectal bleeding, black stools, a lasting change in bowel habits, unexplained weight loss or anemia should be checked promptly by a clinician, regardless of your age or when you were last screened.
This article is general information, not medical advice. For personal care, contact your clinician or call (480) 563-5757.
