Medical questions & health advice by board certified doctors
"When should I start getting a colonoscopy on a regular basis?"
I'm a 45 year old woman with some minor health problems, but I'm concerned about colon cancer. When should I start having a colonoscopy done? How regularly should I have one?
Colon cancer screening partially depends on your family history and race. In general, a healthy person with "average risk" should start screening for colon cancer at the age of 50. This recommendation includes both males and females. However, if you are an African-American, you should start screening for colon cancer starting at the age of 45. This is the 2011 CDC guidelines for colon cancer screening. High risk factors include a personal history of inflammatory bowel diseases such as Crohn's or Ulcerative colitis, or a first-degree relative with colon cancer or polyps. A person at "high risk" from any ethnic background needs to be screened 10 years earlier than when their first-degree relative was diagnosed. For example, if your relative was diagnosed with colon cancer at the age of 50, you need to start screening at the age of 40. Screening for colon cancer for an average risk individual includes a colonoscopy every 10 years or a sigmoidoscopy every 5 years, in addition to a hemacult (blood in the stool) test every year. On the other hand, an individual at high risk will need a colonoscopy every 3-5 years. If colonoscopy is not possible or available, a sigmoidoscopy and a barium enema can be used as a substitute. Virtual colonoscopy, where a patient gets a scan with special contrast, is available at certain centers. This procedure does not require a strict bowel preparation. But if a polyp is found, you would need to undergo a colonscopy to remove it. I would suggest you follow up with your primary care doctor to discuss your risk level.
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