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Colon cancer screenings

Who should be screened, when you should start and answers to other common questions


A lot of people put off their recommended cancer screenings – especially colon cancer screenings like colonoscopies. In fact, according to the Centers for Disease Control and Prevention (CDC), about one quarter of adults have not been screened as recommended.

For some, fear of the prep work and the test itself keep them from scheduling their screening. For others, they’re healthy and don’t have any colon cancer symptoms, so they don’t think they need to be screened. But it’s important to know that colorectal cancers – cancers of the colon and rectum – are the second-leading cause of cancer-related deaths among men and women in the United States.

You want to be as healthy as possible for as long as possible. And you want that for your partner, parents, grandparents, and other close friends and loved ones, too. That’s why we encourage you to get screened and tell those you love to get screened, too.

We know you might have questions about when screenings should start, how often you should have them, whether a colonoscopy is the only screening option, and more. So, to help you find out what you need to know, below are answers to some of the most common questions we get about colon cancer screenings.

What you need to know about colon cancer screenings

Why are colon cancer screenings important? They save lives.

While colorectal cancer is second only to lung cancer in cancer-related deaths in the U.S., it’s also a cancer than can be prevented or detected at an early stage. That’s where screenings come in.

Screenings are how we look for cancer or pre-cancer in people who have no symptoms of the disease. This is important because many people with colon or rectal cancers don’t experience symptoms in the early stages of the disease.

When found at an early stage (before it has spread), the five-year relative survival rate for colorectal cancers is about 90 percent. But less than half of colorectal cancers are found at this early stage. That’s why screenings such as colonoscopies and stool tests are recommended at specific times – they save lives.

Who should be screened for colon cancer and when should they start?

Most colon cancers occur in men and women who are 50 and older. So, colon cancer screenings are recommended for everyone starting at age 50. But for those with certain risk factors, screenings should start earlier – typically at 45. Some of those risk factors include:

  • Family history – While most people with colon cancer don’t have a family history of the disease, family history can increase your risk for getting it. If you have a grandparent, parent, sibling or child who’s had the disease, tell your primary care doctor right away. This is especially true if you have more than one family member with the disease.
  • Race – African American and Native American populations are at a higher risk for developing colon cancer than people of other races.
  • Genes – While just a small percentage of colon cancers are connected to inherited genes, certain gene mutations that are passed down can significantly increase your risk of colon cancer.
  • Lifestyle factors – Smoking, drinking alcohol, poor diet and lack of regular exercise can also increase your risk for colon cancer.

How often should you be screened for colon cancer?

How often you should be screened for colon cancer largely depends on two factors: Your individual colon cancer risk factors and the type of screening test that is chosen.

For example, if you’re 50 or older, at average risk for developing colon cancer and opt for a stool test, you’ll submit a sample once a year until your doctor recommends otherwise. If you opt for a colonoscopy, every 10 years is typically recommended.

On the other hand, if you’re at a higher risk, your doctor may strongly recommend a yearly stool test and/or that you get a colonoscopy every three years.

Ready to talk about your colon cancer screening options? Do it at your next preventive check-up.

At what age can you stop being screened for colon cancer?

Screening recommendations are based on the possible benefits and risks associated with available screening tests. Generally, regular colon cancer screenings are recommended until age 75. Between ages 76 and 85, you should talk with your doctor about the pros and cons of screenings, and make your decision based on your personal preferences and health. After 85, screenings aren’t recommended as the potential harms of screenings can outweigh the potential benefits.

Are colon cancer screenings covered by insurance?

Most screenings are 100 percent covered by insurance, even if you haven’t met your deductible. To find out your level of coverage, call your insurance company.


What type of colon cancer screening options exist?


What is a colonoscopy?

A colonoscopy is what most people think of (and often dread) when it comes to colon cancer screenings. A colonoscopy is a procedure that lets your doctor check the lining of your colon for anything unusual such as inflamed or swollen tissue or polyps, which is the growth of extra skin. Some polyps can become cancerous.

Fecal immunochemical test (FIT)

What is a FIT test?

A FIT test is an annual stool test that screens for colon cancer. The test looks for the presence of blood in your stool, which can be a sign of colon cancer. A FIT test is comfortable, convenient and done right at home.

Should you get a colonoscopy or a FIT test?

The important thing is that you get screened. Depending on your age, health, personal preferences and risk factors, your doctor can help you decide which test to choose. The best colon cancer screening test is a completed test – which means more people are opting for a FIT test.

But it’s important to know that choosing a FIT test doesn’t mean you’ll never need a colonoscopy. If your FIT test comes back positive, your doctor will recommend a colonoscopy to investigate further.

What you need to know about colonoscopies


What happens during a colonoscopy?

During a colonoscopy, your doctor will gently ease a thin, flexible, hollow, lighted scope into your colon (which is also called your large bowel or large intestine). There’s a camera attached to the end of the scope so your doctor can look for abnormalities like colon polyps that may become cancerous. Your rectum and your entire colon are examined.

If needed, your doctor will take tissue biopsies and remove polyps during the procedure.

What does a colon polyp look like? Usually, a colon polyp looks like growth protruding from the wall of your intestine.

How long does a colonoscopy take?

From the time you arrive for your screening to the time you’re discharged, you can plan on everything taking about two hours. But the procedure itself typically takes about 20 to 45 minutes. The amount of time depends on how well your at-home preparation worked, the length of your colon and how many polyps are found and removed.

Learn more about what your experience will be like on the day of your colonoscopy.

Does getting a colonoscopy hurt?

No. Most people don’t feel pain during a colonoscopy, but some do feel a little discomfort such as pressure or cramping as the scope moves through their colon.

Before your colonoscopy begins, you’ll get medications to help you relax and block pain for the duration of the procedure – you may even fall asleep. Your nurse will continuously monitor you. If you need more medication, they’ll give it to you. If you have concerns about taking any medications, your doctor can talk through your options before the procedure.

What happens if a colon polyp is found during a colonoscopy?

If your doctor finds a colon polyp or polyps during your colonoscopy, they’ll remove them and send them to a laboratory for testing.

How long does it take to get your colonoscopy results?

Your doctor may discuss some of the results of your colonoscopy before you leave for home. If you had a biopsy or polyp removed and sent for testing, you should receive a letter within 14 days. If you have an online account with us, you can see your results even sooner.

How do you prepare for a colonoscopy?

In order for a colonoscopy to be successful, your colon needs to be clean. That means you need to take steps to clean it out before the procedure. And usually, this prep work is what people fear the most about a colonoscopy.

Before your procedure, you’ll get very specific colonoscopy prep instructions as well as a combination of prescription and over-the-counter medications. Most of the instructions will be about diet, such as what you can eat before a colonoscopy, what you can’t eat before a colonoscopy and when to stop taking certain medications.

You’ll start making changes to your diet six days before your colonoscopy, but the day before the exam is when the colon cleansing really begins. You’ll start taking your medicine to help empty your colon, and you’ll need to stay close to a bathroom for a few hours as your colon empties.

What are my best colonoscopy prep tips? For starters, make sure you follow your instructions exactly and reach out to your doctor if you have questions. The work you do impacts how successful your screening is. Also, make sure you arrange transportation to and from your screening. You won’t be able to drive after your colonoscopy due the effects of the medications you’ll receive during your procedure.

What can you expect after a colonoscopy?

Immediately after your colonoscopy, your nurse will take you to a recovery room. You’ll probably be monitored for about 30 minutes before you’re discharged with specific care instructions. If you were sedated during the exam, you’ll probably feel sleepy for a few hours. You may be a little gassy too. As for what you can eat after a colonoscopy, the good news is that you can return to your regular diet.

If you have more questions, read this handout that I give to my patients on what to expect during and after a colonoscopy.

Is there risk of complications when you have a colonoscopy?

Yes. Like any procedure, a colonoscopy does carry some risk. But colonoscopy complications are rare. Possible risks include a perforation of the colon lining, bleeding where a biopsy was taken or a polyp was removed, a missed diagnosis if a polyp couldn’t be seen during the procedure, an allergic reaction to sedation medication, and postcautery syndrome.

What you need to know about FIT tests

How does a FIT test work to screen for colon cancer?

Your colon is an important part of your digestive system, which works to process the food we eat and pull out food nutrients. Stool – your poop – is what is left over after digestion is done. And since it travels through your entire digestive track, your stool can hold clues about what’s happening inside your colon. And a FIT test is designed to look for blood in your stool, which can be a sign of colon cancer.

How often do you need to do a FIT test to screen for colon cancer?

A FIT test is an annual colon cancer screening. And yes, it’s important to stick with it until your doctor recommends otherwise.

How do you prepare for a FIT test?

The only preparation for a FIT test is to “schedule” your screening. All you need to do is call your clinic, let them know it’s time for your annual FIT screening, and the testing kit will be mailed to your home. Once you receive your kit, just follow the instructions to collect a small sample of your stool and mail it in for testing.

What happens if your FIT test is positive?

If your FIT test is positive, your doctor will recommend a colonoscopy as the next step to investigate what may be causing the bleeding.

Are there any risks with a FIT test?

Since the FIT test is non-invasive, the test itself doesn’t pose any risks. But it is possible to get a “falsely negative” result. This means that a pre-cancerous or cancerous polyp can be present in the colon, but the test may still be negative.

Now is always the time to cover your colon

Colon cancer screenings save lives. So, don’t delay the conversation around this important preventive care. Plan to talk with your primary care doctor about your screening options at your next preventive check-up. If you’re ready to schedule your colonoscopy, call your local clinic.

And remember, screening guidelines only relate to people who have no signs or symptoms of colon or rectal cancer. If you have symptoms like blood in your stool, changes in your bowel habits or abdominal pain, don’t ignore them and see a doctor right away. They may be signs of cancer or another health condition.

Ready to talk about your colon cancer screening options? Do it at your next preventive check-up.

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