Northwest Florida Gastroenterologists: Colonoscopy Age Recommendation Update

For decades, the recommended age for getting your first colonoscopy was 50. However, in 2018, the American Cancer Society (ACS) lowered the recommended age to 45 for individuals at average risk of colorectal cancer. This change was made in response to a concerning trend: colorectal cancer rates have steadily increased among younger adults over the past several years. Recently, thanks to the new guideline, private health insurance companies will be required to cover colorectal cancer screenings without copays from age 45 to 75, as mandated by the Affordable Care Act.

Colorectal cancer is the third most common cancer diagnosed in men and women in the United States. The ACS estimates that there will be over 100,000 new cases of colon cancer and over 44,000 new cases of rectal cancer in the United States in 2023.

Several factors can increase an individual’s risk of developing colorectal cancer, including a personal history of inflammatory bowel disease, a family history of colorectal cancer, or a genetic predisposition to colorectal cancer. However, most individuals who develop colorectal cancer have no known risk factors.

The rationale behind the new guidelines is based on the observation that the incidence of colorectal cancer in younger people has increased by about 2% per year since the mid-1990s. In addition, younger patients with colorectal cancer are more likely to be diagnosed at later stages when the cancer is harder to treat.

The new recommendation for starting colonoscopies at age 45 is based on data from several studies showing that the incidence of colorectal cancer in individuals under age 50 has been increasing. The ACS notes that these younger patients are often diagnosed with more advanced stages of cancer and have a higher risk of dying from the disease.

Colonoscopies are the gold standard for colorectal cancer screening because they can detect precancerous polyps that can be removed before they develop into cancer. Screening at age 45 can allow for the early detection of colorectal cancer or precancerous polyps, significantly improving treatment outcomes.

While colonoscopies are generally safe and effective, they can be costly and require significant preparation. However, the benefits of early detection and prevention of colorectal cancer far outweigh the inconvenience and discomfort of the procedure. Additionally, there are other screening options available such as stool-based tests that are less invasive and may be more suitable for some individuals.

The decision to lower the recommended age for colonoscopy from 50 to 45 years old was based on the increasing incidence of colorectal cancer in younger adults. It is essential to discuss with your healthcare provider when to begin colorectal cancer screening based on your personal medical history and risk factors. Early detection and prevention can save lives.

If you have reached the age when a colonoscopy is recommended based on your own risk factors, contact Digestive Diseases Center, and request a consultation with one of our gastroenterology physicians.