How Often Should You Get a Colonoscopy?

While some health issues can take you by surprise, a colorectal cancer diagnosis shouldn’t be one of them if you keep up with your screenings. 

In the United States, colorectal cancers are the third leading cause of cancer-related deaths for both men and women — with about 52,550 deaths predicted for 2023. Avoiding this unthinkable outcome often comes down to early detection and treatment, which makes regular screening invaluable.

As experts in colorectal health, the team of board-certified surgeons here at Fairfax Colon & Rectal Surgery performs hundreds of colonoscopies each year. We present a few rules of thumb here to help you figure out when you should come to see us for this critical screening.

Your first colonoscopy

Let’s start with the very first colorectal cancer screening, which we used to recommend at age 50 if you were of average risk. Thanks to an uptick in colorectal cancer diagnoses in younger people (under the age of 50), the American Cancer Society, alongside the team here, now recommends that you get your first colonoscopy at age 45.

When we say “Average risk,” it means that you don’t have one of these factors:

• Immediate family history of colorectal cancer or problematic polyps
• Personal history of inflammatory bowel conditions, such as Crohn’s disease
• You have an inherited gene variant associated with colorectal cancer

We also want to include some lifestyle risk factors here, such as smoking or obesity. Also, if you’re having any symptoms, such as rectal bleeding, we will want to conduct a colonoscopy to see what’s going on inside your rectum and/or colon.

If you’re unsure about your risks, it’s a good idea to sit down with us so that we can check for any red flags. If you do have a potentially higher risk for colorectal cancer, we may want to perform your first colonoscopy sooner than age 45.

Follow-up colonoscopies

The results of your first colonoscopy will dictate your follow-up schedule to a large degree. In the best-case scenario, we don’t find any growths (polyps) during your colonoscopy, so you don’t have to have another colonoscopy for 10 years.

If we do find polyps, we remove them for further study. If the polyps don’t contain any abnormal cells, you’re usually clear for 10 years. If we do find suspicious cells, we’ll likely want to screen you sooner.

If you have an inflammatory bowel disease like ulcerative colitis, it’s a good bet that we’re going to want to screen you with regular colonoscopies every 2-5 years.

After age 75, we determine whether further screening are necessary. Colorectal cancers are slow-growing, and the risks of putting you under sedation or general anesthesia for the colonoscopy grow as you age.

While these are some good general guidelines, the best way to figure out your own colonoscopy schedule is to come see us. To get started, please contact one of our offices in Fairfax, Fair Oaks, Alexandria, Gainesville, Woodbridge, or Lansdowne, Virginia, to schedule an appointment.