Colorectal Screening: When Do I Need a Colonoscopy?

Colorectal cancer numbers are unfortunately rising in young people – meaning before 50 years old. The reason is not clear, but it goes to show why it’s more important than ever to understand screening recommendations and processes, and how they are crucial to your health.

Abnormal cells that form into polyps in the body take about 10 to 15 years to potentially develop into colorectal cancer. By screening and identifying these abnormal cells and polyps through tests such as a colonoscopy, you and your physician can intervene and remove them before they have the chance to turn into cancer. In addition to detection and intervention, screening can also find colorectal cancer early, when it’s smaller and easier to treat.

Screening Recommendations

Colorectal cancer almost always develops in precancerous polyps – growths – in the colon or rectum. Screening identifies these polyps, and removing them prevents cancer from forming. Colorectal polyps and colorectal cancers don’t always cause symptoms, especially in the early stages. That is why getting screened regularly for colorectal cancer is so important.

The American Cancer Society recommends colon screening for everyone, beginning at age 45. If you have a strong family history of colorectal polyps or cancer, talk with your doctor about your risk level. Earlier screening may be recommended.

Screening Options

As the only test that examines the entire colon, colonoscopy remains the gold standard for colon screening. However, other screening processes are available, so it’s important to speak with your physician to learn about the various screening types and determine which option is best for you.

Stool tests look at the stool for possible signs of colorectal cancer or polyps. They are typically done at home, so many people find them easier than tests like a colonoscopy. However, this type of test needs to be done more frequently and has a higher false positive rate than a colonoscopy. A colonoscopy will be required if stool test results are abnormal, so if you used your insurance to pay for the at-home test, the follow-up colonoscopy may not be covered.

Colonoscopy is a screening test that involves a colonoscope – a lighted camera on the end of a flexible tube – that passes through your anus and rectum into your colon. Along the way, it sends pictures of the inside of your large intestine to a screen that helps your physician identify any polyps that are present. Polyps can also be removed during the procedure, and tissue may be biopsied afterward. Some preparation is required for a colonoscopy, but your physician will guide you through the process, which can begin a few days before the screening. Some find the preparation challenging, but the benefits of cancer prevention are invaluable. A colonoscopy also has the longest interval between tests if the exam is normal. To schedule a colonoscopy at Capital Health, visit capitalhealthcancer.org/colonoscopy or call 609.303.4444.

Colorectal Cancer Signs and Symptoms

Colorectal cancer may not show any signs or symptoms, which is just another reason why screening is so important. However, if you notice any of these signs, it’s crucial that you speak with your doctor to discuss what it could mean.

… Sudden diarrhea, constipation, or other unusual bowel habits such as narrowing of the stool, that last for more than a few days

A feeling that you need to have a bowel movement that is not relieved by having one

… Rectal bleeding with bright red blood

… Blood in the stool, which might make it look dark brown or black

… Abdominal pain or cramping

… Weakness and fatigue

… Noticeable weight loss