How Often Should You Get a Colonoscopy?

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Yearly, routine checkups or physicals with a doctor are considered a good health practice for nearly every person.

As we age, more and more procedures are added to the routine — e.g., blood work to check things like cholesterol and heart health.

Colonoscopies are another procedure that will eventually make that list. But what are colonoscopies exactly? And how often should you get one?

Let’s take a look at some of the factors that help answer that very question.

What Is a Colonoscopy?

The colon, also known as the large intestine or large bowel, is an organ that is part of the digestive system. Once the food is broken down by the stomach and nutrients are absorbed by the small intestines, the remaining waste is moved into the colon.

In the colon, water is absorbed, and gut bacteria help break down the remaining material. From here, the remaining waste is moved into the rectum, where it is eventually expelled from the body.

Colonoscopy is a procedure in which a physician uses a scope to examine the large intestine (colon) and rectum. Typically, this common screening test is used to check for changes and/or abnormalities.

During the procedure, a long, flexible scope is inserted into a patient’s rectum. A small video camera is attached to the tip of the scope, allowing the doctor to examine the inside of the large intestines.

There are also procedures known as virtual colonoscopies, or computerized tomography, in which radiologists use a computer and x-rays to create a virtual image of the large intestines — its effectiveness compared to a standard colonoscopy is debatable.

Why Is a Colonoscopy Performed?

Colonoscopies are most commonly used as a screening tool. A colonoscopy can be used to detect many different types of abnormalities and conditions in the large intestine.

Physicians may recommend colonoscopies to:

  • Investigate intestinal symptoms – A colonoscopy can help a doctor determine the cause of intestinal symptoms, such as rectal bleeding, chronic constipation or diarrhea, abdominal pain, ulcerative colitis, and unexplained weight loss.
  • Screen for colorectal polyps and colon cancer – Colonoscopies are used to screen for colon cancer. Typically, this begins by screening for colorectal polyps, which can lead to colon cancer. These would be considered preventive screenings.

The American College of Surgeons states that roughly 90 percent of polyps and tumors can be detected through routine colonoscopy screenings. Finding these early can make all the difference in terms of treatment and overall outcome.

How Often Should You Get a Colonoscopy?

As discussed, a colonoscopy is typically used as a preventative measure as it screens for conditions such as colon cancer. However, the frequency of getting colonoscopies really comes down to your risk factors.

Colonoscopy Guidelines

On average, most individuals get their first colonoscopy screening test around age 45 to 50. These would be those who are considered “average risk.” But, this age could be earlier depending on your family medical history and risk factors.

If you are in good overall health and do not have a personal or family medical history of bowel disease, then it is recommended to get your first colonoscopy at age 50. However, the American Cancer Society recommends age 45.

The American College of Physicians recommends those at average risk continue with routine colonoscopy screenings every ten years who meet the following criteria:

  • 50 to 75 years of age
  • Are at moderate risk of colon cancer
  • Have a life expectancy of at least ten years

Polyps or Colon Cancer, Once Every Five Years

When it comes to having a family history (e.g., a close relative has been diagnosed) of colorectal polyps or colon cancer, there is no such thing as getting a colonoscopy “too early.”

But if this applies to you, it is generally recommended to start getting colonoscopies by age 40 or before the family member’s youngest diagnosed age — or whichever comes first.

Recommended screening is every five years as you would be considered higher risk.

Colon cancer or certain types of polyps, One to Three years

If you have a personal history of colon cancer or have had polyps removed in the past, the frequency of routine colonoscopies is greatly increased.

Those who’ve had colon cancer typically receive yearly colonoscopies after surgery or treatment, but your doctors will ultimately determine this.

Those who’ve had polyps removed during a colonoscopy typically receive colonoscopies every three years, but this can be shorter depending on the risk factors and the doctor’s discretion. It depends on the type, size, and number of polyps.

​​ Inflammatory Bowel Disease, One To Three years

If you’ve been diagnosed with certain gastrointestinal conditions, like Inflammatory Bowel Disease (IBD) you're considered a higher risk for colorectal cancer and will require more frequent colonoscopies. This includes Crohn’s Disease or ulcerative colitis.

IBD refers to a condition in which the colon is inflamed, typically over a long period of time. Generally, those who’ve been diagnosed with an IBD condition start receiving colonoscopies at least eight years after initial diagnoses.

For example, if you have a history of Crohn’s Disease or ulcerative colitis, you can expect to have a colonoscopy within eight years after initial diagnosis (or at age 50, whichever comes first).

Follow-up colonoscopies can be expected every 1 to 3 years, depending on risk factors and previous findings.

Bottom Line

Colonoscopies are an essential screening tool that helps doctors examine the condition of the large intestine and check for diseases.

The frequency of colonoscopies depends on several factors, namely your level of risk, which includes both personal and family medical history.

It is a good idea to consult your physician to discuss your risk factors and when colonoscopies may be appropriate for you.


Colonoscopy | NIDDK

Virtual Colonoscopy | NIDDK

Colorectal Cancer Guideline | How Often to Have Screening Tests |

Colorectal Cancer Risk Factors | Hereditary Colorectal Risk Factors |

Colonoscopy | American College of Surgeons

Healthy Directions Staff Editor