When to Get a Colonoscopy

50 is the magic age for getting a colonoscopy screening.

Why 50? Most gastrointestinal cancers are more prevalent as a person ages. So the guidelines are set to benefit the largest numbers of patients by recommending “screening” tests to detect cancer while it can still be removed completely and cured.

The key word here is screening. That means there are no symptoms, and the doctor is just doing surveillance. If a person has symptoms, family cancers in the genes or other conditions that increase the chance of cancer, the magic age of 50 doesn't apply and colonoscopy can and should be done at any time to diagnose a problem.

There are clinical guidelines for continuing follow-up screenings, and here is where it gets muddled. Gastroenterologists often don't adhere to these guidelines, and patients can be confused as to when they should get a repeat exam.

These guidelines assume the baseline colonoscopy was complete and the physician was able to get the scope up to the cecum; that the bowel prep was adequate for good visualization; and that any polyps were removed. If you have a colonoscopy and a polyp was removed, remember to ask for the pathology report and keep it. This report shows what type of polyp it was—because that makes a difference as to when the next colonoscopy is due.

Here are the guidelines as recommended by the US Multi-Society Task Force on Colorectal Cancer:

No polyps

repeat in 10 years

Small (<10 mm) hyperplastic polyp in rectum or sigmoid

repeat in 10 years

1–2 Small (<10 mm) tubular adenomas

repeat in 5–10 years

3–10 tubular adenomas

repeat in 3 years

10 adenomas

repeat in less than 3 years

Any adenoma >10 mm

repeat in 3 years

Any adenoma with villous elements (villous or tubulovillous) or with high-grade dysplasia

repeat in 3 years.

Any sessile or serrated adenoma

repeat in 3 years

Serrated polyposis syndrome

repeat in 1 year

When can you safely stop screening? If the patient's life expectancy is less than 10 years, there is no reason to continue with screening colonoscopy.

In medicine, it is just as important to prevent overuse as it is to make sure everyone gets the right screening at the right time. If you’re lucky enough to have a good primary care physician, she will make sure you are tested at the right time.

More and more people are trying to manage their own health without expert help—so knowing your pathology report and following these guidelines will help you with timing.

Source: Healthwise