Colonoscopy is considered the gold standard for finding and removing -- and possibly preventing -- colorectal cancer. It can detect up to 95% of colon cancers and can be used to remove precancerous polyps before they develop into cancer. So it’s important to know when you should begin colonoscopy screening: age 40 or 50?
Current guidelines recommend that colonoscopy screening begin at age 50 for individuals at average risk for getting colorectal cancer. But might we prevent more cancers and save more lives if screening were to start at age 40?
Researchers explored this question by analyzing the results of colonoscopies performed on individuals age 40 to 59 as part of an employer-provided wellness program. During the 27-month period studied, 553 people age 40 to 49 and 352 aged 50 to 59 had a screening colonoscopy. Polyps were removed from 79 people age 40 to 49 and from 56 people in the 50 to 59 age group.
No differences were seen between the two age groups in the polyps' size or location in the colon. However, the researchers did find more advanced neoplasms in the older group than in the younger group -- 3 (4%) and 11 (2%), respectively.
More studies are needed to determine whether screening at age 40 would reduce the incidence of colorectal cancer and be cost effective. For now, doctors recommend scheduling your first colonoscopy at age 50 unless you're at higher-than-average risk for colorectal cancer or you develop symptoms. Study reported in the journal Gastroenterology (Volume 134, page 1311).
