This is not a substitute for direct care by YOUR doctor. Confirm with your doctor before doing any of the following.

The United States Preventative Service Task Force recommends that adults start screening colonoscopies at 45 years old and continue them until at least 75 years old, done every 10 years for patients without abnormal findings on colonoscopy. Between 75 and 85 years old, whether or not to continuing screening colonoscopies is determined by patients and their doctors on an individualized basis. 

Colonoscopy is the only screening option that can reliably catch polyps before they turn into cancer. These polyps can usually be removed during the colonoscopy. Blood thinners generally need to be stopped before polyps can be removed. The sedation used for colonoscopy can be a problem for patients with significant heart or lung disease. The risk of injuring the bowel during a colonoscopy is approximately 1 out of every 1,000 - 2,000 procedures.

Cologuard is a test that can be done at home then mailed to a laboratory. Cologuard evaluates your stool for tumor DNA and for blood. It should be done every 3 years. It does not reliably catch pre-cancerous lesions. If it is positive, the next step is a colonoscopy to look at the colon and see if there is a concerning area. If you have rectal bleeding, the test will be positive and you should proceed with colonoscopy without doing a Cologuard test first. The Cologuard test is not invasive, can be done wherever you live, and has almost no risk for the test itself. The risk of this test missing a colorectal cancer is approximately 8% or 8 out of 100. 

If you have a first degree relative (mother, father, sister, or brother) who has been diagnosed with colon or rectal cancer, then you should start screening 10 years before the age at which your relative was diagnosed with cancer. There are many guidelines for patients with different inherited diseases or family histories of cancer. This should be further discussed with your doctor to determine what screening schedule is right for you.

American Cancer Society. Colorectal Cancer Screening Tests. https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/screening-tests-used.html. July 31, 2024.

Cologuard. https://www.cologuardhcp.com/resources/faq. Jan 28, 2025.

Lohsiriwat V. Colonoscopic perforation: incidence, risk factors, management and outcome. World J Gastroenterol. 2010 Jan 28;16(4):425-30. doi: 10.3748/wjg.v16.i4.425. PMID: 20101766; PMCID: PMC2811793.

National Comprehensive Cancer Network: Guidelines: Colon Cancer. Version 6.2024. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1428

U.S. Preventative Service Task Force. Final Recommendation Statement