Is it time to schedule your colonoscopy? Screening should start at age 45, or earlier if you have risk factors like a family history of colorectal cancer. Talk to your doctor about what age is right for you.

If you are having a colonoscopy soon, you probably have a lot of questions. Summit Health’s colorectal surgeon, David Hong, DO, tells us what we need to know about the procedure including what to expect and why early detection of colorectal cancer is so critical.   

Why is it important to have regular colonoscopy screening tests?

Colorectal cancer is the second leading cause of cancer death in the U.S. for men and women combined according to the American Cancer Society.

A colonoscopy is the best way to detect and prevent colorectal cancer. Colon and rectal cancers develop from abnormal growths or polyps. In addition to screening for cancer, a colonoscopy is used to detect these abnormal polyps and remove them. This greatly reduces the risk of developing cancer in the future.

Learn more about why colonoscopy remains the proven gold standard in colorectal cancer detection.

What should you expect during a colonoscopy?

I want my patients to be informed so I’m transparent leading up to the coloscopy. Often times, the hardest part about a colonoscopy is the bowel prep required the day before your colonoscopy. You will need to drink a liquid substance and clear your bowels.

What do you wish patients knew about colonoscopy?

The procedure is not painful. Patients are asleep and comfortable with the help of IV sedation. An anesthesiologist is present to monitor you the entire time and provide the sedation. The actual procedure takes about 20 to 30 minutes. You may feel a little groggy afterward. Patients may resume normal activities the next day.

Are there any myths regarding colonoscopy that you want to clear up?

Just because you do not have symptoms, doesn't mean you do not need a colonoscopy. Once symptoms develop, it usually indicates that the cancer has become more advanced. Early detection is key and that’s why getting a colonoscopy starting at the age of 45 is important.  

When should you start colonoscopy screening and how often should you go?

Screening should begin at age 45 for an average-risk individual. Patients with a family history of colorectal cancer or those with certain medical conditions may be advised to start screening earlier. Colonoscopy is generally repeated every 10 years in average-risk patients if no polyps are found. Talk to your doctor about what is right for you.

Why is it important to understand your family history of colorectal cancer?   

Some colon and rectal cancers are hereditary. It is important to know what family members (parent, grandparent, siblings, etc.) had colon cancer and at what age it was detected. If you have any first-degree relatives with a history of colon cancer, your physician will recommend you are screened earlier than age 45.

How do I schedule a colonoscopy appointment?

Many healthy, age-appropriate individuals can book their screening online with Direct Access Colonoscopy and do not need to see a physician for clearance. Patients with serious medical conditions such as poorly controlled diabetes, serious cardiac disease, severe breathing issues or kidney problems should meet with a gastroenterologist to discuss their health history and risks for the procedure.  

Are fecal tests helpful in detecting colorectal cancer?

Fecal tests can be a nice adjunct tool that we use to assess for possible polyps or colon cancer, but they should never be used as a substitute for colonoscopy in an otherwise healthy individual.

Fecal tests are well suited for patients who have serious conditions that put them at a higher risk of undergoing IV sedation or if patients have severe reservations about undergoing the procedure. Otherwise, I strongly recommend an average healthy patient just have a colonoscopy as it is the best means to detect polyps, colon cancer or any other abnormalities of the colon.

What can you do to reduce your risk of colon cancer?

Maintain a healthy lifestyle by eating a well-balanced diet with a lot of fiber, moderating your intake of red meats and alcohol, quitting smoking, and exercising regularly.

Talk to your doctor about colonoscopy screening at your next appointment. Remember, screening should begin at age 45 or earlier in those with family or medical history. You may also be eligible for Direct Access Colonoscopy, which allows healthy, age-appropriate patients to schedule a screening colonoscopy without a pre-procedure visit.