A colonoscopy doesn’t have to scare you

The message is clear. If you are over 50 years old and you have yet to undergo your first potentially life-saving colonoscopy procedure, you’re putting your health at risk.

“What are you waiting for?” asks gastroenterologist Sophie M. Balzora. Balzora is a practicing physician at NYU Langone Health and is also a fellow at the American College of Gastroenterology, where she serves as chair of the Public Relations Committee.

You may have heard before that 50 is the magic age for your first colonoscopy. That’s still accurate, Balzora says.

“Age 50 is really the sweet spot. We want to catch patients at just the right time — when we can actually implement a preventive approach.”

Screening too late means that instead of finding the precancerous polyps that can be removed before they become more worrisome, doctors might instead find cancerous cells. And screening too early often means that no warning signs are found. That can lead patients to believe that the procedure is unnecessary, unhelpful or cost prohibitive.

While men get much of the attention, there is almost no difference between the incidence rates of colorectal cancer in men and women. That means 50 is the right age for women to start receiving this type of preventive care as well.

When performing a colonoscopy, a doctor looks at the patient’s large intestine for signs of polyps, other growths or a narrowing of the internal passageways. The task is accomplished via a small, flexible camera with a light at the end that is inserted into the patient’s rectum. A colonoscopy takes an average of 20–30 minutes, and patients are usually sedated to eliminate discomfort.

While any medical procedure can cause anxiety, Balzora says patients should think about the life-saving reality of early detection of colorectal cancers.

“It’s important to remember that it’s a minor procedure, and it can truly save your life. I find that my patients are relieved after having the procedure, and that what they’ve read or heard about the procedure is oftentimes much more daunting than the actual procedure turns out to be, which is reassuring,” Balzora says.

There are several factors that should encourage men and women to receive a colonoscopy prior to reaching 50 years of age, such as a family history of colorectal cancers. Ethnicity is also a factor, and the ACG recommends that black men and black women get their  first colonoscopy at age 45 because of an increased occurrence rate.

Despite lower-than-average screening rates in many minority populations, progress is being made to share the message about the potentially life saving effect of early screening and detection. The ACG supports a nationwide effort to screen 80 percent of eligible individuals by the end of 2018.

“We can get there if we continue to spread the message that colon cancer is preventable, beatable and treatable,” Balzora says.


The American College of Gastroenterology and many other medical research organizations agree that 50 is the right age for most Americans to undergo their first colonoscopy. But several factors should be viewed as a sign to get screened for colorectal cancer before age 50.


Factors that may prompt early screening include:

  • A family history of colorectal cancer or a family history of certain types of precancerous polyps, particularly in a first-degree relative, and especially in a first-degree relative under the age of 50
  • Multiple second-degree family members with colorectal cancer
  • A family history that includes members under 50 with other kinds of cancers, such as ovarian or endometrial cancer
  • Being of African descent
  • A diagnosis of inflammatory bowel disease (such as Crohn’s or ulcerative colitis)

Also, these physical symptoms should prompt you to talk with your health care provider to see if a screening is required:

  • A change in your bowel movements, such as frequency, consistency or quality
  • Blood in the stool or bowl or on toilet paper
  • A sudden loss of appetite or unintentional weight loss
  • Sudden or unexplained intestinal pain

Source: American College of Gastroenterology