Do I Need a Colonoscopy?

The question of whether or not a patient needs a colonoscopy depends on a number of factors. This medical procedure involves looking into the intestinal tract with a rectally-inserted camera, and it is performed to look for signs of polyps, lesions, and other health problems in the colon. While getting a colonoscopy can be uncomfortable, this test can be critically useful in identifying the early signs of colon cancer and other health conditions.

As a general rule, if a patient is over age 50, he or she will need a colonoscopy every 10 years until the age of 75 or 80, since the biggest risk factor for colon cancer is age. A virtual colonoscopy, which involves using medical imaging equipment to get a picture of the colon, can also be used, along with tests of feces to look for signs of bleeding and ulceration in the colon.

If a patient has a family history of cancer, he or she will need a colonoscopy more frequently, due to the increased risk of cancer. Cancer in close family members is an indicator for a colonoscopy every five years starting at age 40, and a high incidence of cancer, especially colon cancer, in the family history would suggest that a patient may need a colonoscopy every three years starting at an age 10 years below that of the youngest family member diagnosed with cancer. In other words, if a patient's father was diagnosed with colon cancer at age 35, the patient should plan on getting a colonoscopy at age 25 and every three years thereafter.

A patient may also need a colonoscopy if he or she has a history of colon polyps or bowel disease. A doctor will make recommendations based on the individual patient's condition, but routine screening may need to start as young as age 15, with follow up screenings between two and five years, depending on the patient's circumstances. People with a history of familial adenomatous polyposis, Crohn's disease, irritable bowel disease, and other bowel conditions may need a colonoscopy on a regular basis to check for early signs of a problem.

Beyond the basic colonoscopy recommendations used as rough guidelines in patient care, there may be specific circumstances in which a doctor recommends a colonoscopy as part of a diagnosis and treatment plan. When a doctor requests that a patient get a colonoscopy, it is a good idea to follow the recommendation. If the patient has recently received a colonoscopy screening, he or she can ask if the doctor can review the earlier results and withdraw the recommendation for a repeat, but the doctor may feel that the patient's condition merits a second look into the intestines.