A colonoscopy is done by sending a narrow, bendable tube with a camera on the end into your lower bowels to look for abnormalities in your colon, or large intestine. It’s the primary method of testing for colorectal cancer.

The procedure can also be used to remove small pieces of tissue to send to a lab for analysis. This is done in case your doctor suspects that tissue is diseased or cancerous.

Who needs a colonoscopy, when should you start getting them, and how often do you need to get a colonoscopy based on your health? We cover that in this article.

By age 50, you should start getting regular colonoscopies no matter your gender or overall health.

As you age, your risk of developing polyps and bowel cancer increases. Getting routine colonoscopies helps your doctor find abnormalities early so they can be quickly treated.

You should consider getting colonoscopies earlier in your life if you have a family history of bowel cancer or have any previously diagnosed conditions that affect your digestive tract, including:

You may also consider getting a colonoscopy more than once a year if your risk for bowel conditions is especially high or you have consistent symptoms that cause your bowels to get irritated or inflamed.

It’s recommended that you get your first colonoscopy at age 50 if you’re in good overall health and you don’t have a family history of bowel disease.

This recommendation may be lowered to 40 or below with the new set of U.S. Preventive Services Task Force (USPSTF) guidelines being drafted by experts.

Get a colonoscopy as often as a doctor recommends if you have a diagnosis of a bowel condition like IBS or ulcerative colitis. This can help ensure that your bowels stay healthy and complications are treated as soon as possible.

Ask your doctor about having a colonoscopy during one of your physical exams if you’re over age 50 or have a bowel condition.

This allows your doctor to check your colon health at the same time that you get your overall health assessed.

There’s no such thing as too early for a colonoscopy if your family has a history of bowel cancer.

The American Cancer Society recommends that you should start getting regular colonoscopies when you turn 45 if you’re at average risk for cancer. The numbers for average risk is about 1 in 22 for men and 1 in 24 for women.

You may need to start earlier if you’re at high risk or if you have a previous bowel cancer diagnosis. Anecdotally, some doctors recommend getting screened as young as 35 if a parent was previously diagnosed with colorectal cancer.

It’s important to note that without a cancer diagnosis, some insurance companies can limit the frequency with which you can get screened, so if you’re screened at 35, you may not be covered for another screening until you’re 40 or 45. Research your own coverage.

Who’s at risk of colorectal cancer?

Some conditions or family health histories can put you at a higher risk of colorectal cancer.

Here are some factor to consider earlier or more frequent colonoscopies because of a higher risk of colorectal cancer:

Polyps are tiny growths of excess tissue in your colon. Most are harmless and can be removed easily. Polyps known as adenomas are more likely to become cancerous and should be removed.

Polyp removal surgery is called polypectomy. This procedure can be done during your colonoscopy if your doctor finds one.

Most doctors recommend getting a colonoscopy at least 5 years after a polypectomy. You may need one in another 2 years if your risk for adenomas is high.

You’ll probably need a colonoscopy every 5 to 8 years if you have diverticulosis.

Your doctor will let you know how often you need a colonoscopy if you have diverticulosis depending on the severity of your symptoms.

Your doctor may recommend that you have a colonoscopy every 2 to 5 years if you have ulcerative colitis.

Your cancer risk increases about 8 to 10 years after diagnosis, so regular colonoscopies are key.

You may need them less often if you follow a special diet for ulcerative colitis.

Most people should get a colonoscopy at least once every 10 years after they turn 50. You may need to get one every 5 years after you turn 60 if your risk of cancer increases.

Once you turn 75 (or 80, in some cases), a doctor may recommend that you no longer get colonoscopies. The risk of complications can outweigh the benefits of this routine check as you get older.

Colonoscopies are considered mostly safe and noninvasive.

There are still some risks. Most of the time, the risk is outweighed by benefit of identifying and treating cancer or other bowel diseases.

Here are some risks and side effects:

  • intense pain in your abdomen
  • internal bleeding from an area where tissue or a polyp was removed
  • tear, perforation, or injury to the colon or the rectum (this is very rare, happening in less than 0.002 percent of colonoscopies)
  • negative reaction to anesthesia or sedative used to keep you asleep or relaxed
  • heart failure in reaction to substances used
  • blood infection that needs to be treated with medications
  • emergency surgery needed to repair any damaged tissue
  • death (also very rare)

Your doctor may recommend a virtual colonoscopy if you’re at a high risk of these complications. This involves taking 3D images of your colon and examining the images on a computer.

If your health is generally good, you’ll only need a colonoscopy once every 10 years after you turn 50. The frequency increases with various factors.

Talk to a doctor about getting a colonoscopy earlier than 50 if you have a family history of bowel conditions, are at higher risk for developing colon cancer, or have previously had polyps or colon cancer.