What to Know About Colonoscopies After 50

Medically Reviewed by Carmelita Swiner, MD on April 07, 2023
3 min read

As you get older, it’s important to get regular health screenings. By taking preventative measures, you can identify the signs of major health conditions before they become problems.

More people are getting a colorectal cancer diagnosis before age 50. Because of this, doctors are beginning to recommend colonoscopies, or colon screenings, between the ages of 45-49. But how often should you get a colonoscopy after you turn 50? 

A colonoscopy is a preventative screening that is conducted even if you have no signs of colon cancer. If your doctor suspects that you have colon cancer, he may order a diagnostic exam in addition to a colonoscopy. 

Colorectal cancer primarily develops from abnormal polyps present in the colon or rectum. By identifying and removing these growths, your risk of getting colon cancer is reduced. A colonoscopy can aid in identifying these growths before they become cancerous. 

What to expect. The procedure is completed using a long, flexible tool called a colonoscope. Your doctor sees inside your colon using a small camera and light at the end of the tool. During your colonoscopy your doctor may:

  • Clean your colon using a small water jet
  • Remove any liquids, including stool, via suction
  • Inject air into your colon so it is easier to see
  • Use surgical tools to remove tissue or polyps for testing
  • Treat any problem areas identified during the exam‌

In addition to cancer, a colonoscopy helps to identify other colon issues like bleeding, inflamed tissue, and ulcers.

Cons of a colonoscopy. A colonoscopy is a common and safe procedure, but it isn’t without risks. Occasionally the tools used cause heavy bleeding, tears, and inflammation. You may be sore or have pain after the procedure, too.

Because you’re sedated during a colonoscopy, you’ll need to have someone drive you home afterward. You may miss a day of work to recover from the sedation and side effects of the procedure.

Preparing for a colonoscopy. You won’t be able to eat or drink for a certain amount of time before your procedure. Your doctor gives you fasting instructions and prescribes a laxative to clear your bowel for the procedure. 

If you’re taking any medications that could interfere with the colonoscopy, your doctor will provide instructions on when to stop taking them. Medications like aspirin and ibuprofen that prevent your blood from clotting may need to be stopped before your procedure. 

Get your first screening at age 45. If you’re at average risk, you should have a colonoscopy once each decade through age 75. If you’re at a higher risk for colon cancer, your doctor may recommend a colonoscopy every five years instead. 

Risk factors. Talk to your doctor about risk factors to determine when you need your first colon screening and how often to get them after that. You’re at a greater risk for developing colon cancer if you have a personal or family history of:

  • Colorectal cancer
  • Certain types of polyps
  • Inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease
  • Hereditary colorectal cancer syndrome

If you’ve been treated for prior cancer, especially using radiation to your abdomen, you’re also at a higher risk for colon cancer. 

Colonoscopies after age 75. Once you turn 75, you may get your doctor’s approval to stop getting colonoscopies. If you’ve had consistent colonoscopies with no signs of cancer or pre-cancer, you may be in the clear. Talk to your doctor first before making any decisions about future testing.

Depending on your personal and family history, your doctor may suggest alternative screening tests in place of a colonoscopy. If you’re at average or less-than-average risk for colon cancer, less invasive screening options are available, including:

  • Highly sensitive fecal immunochemical test (FIT)
  • Highly sensitive guaiac-based fecal occult blood test (gFOBT)
  • Multi-targeted stool DNA test (mt-sDNA)

Keep in mind that these screenings require greater frequency than a colonoscopy. Plan on completing one of these options every one to three years.

Not completing screenings. Also keep in mind that skipping colonoscopies leaves you at risk. Without early detection, cancer may progress and be untreatable by the time you exhibit symptoms. Or, if it is treatable, you may be left with lifelong health impacts.