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Colonoscopy Screening Guidelines

Receiving regular screening colonoscopies is an important part of colon cancer prevention and maintaining your best health. Here's what you need to know about how often you should schedule colonoscopies and what to expect when you do.

Everyone knows that colonoscopies are an important part of health screening, but what you might not fully understand is why. Recent colonoscopy guidelines have changed, so let’s discuss what exactly a colonoscopy is, why they’re so important, and what you need to know about getting one scheduled.

What Is a Colonoscopy?

A colonoscopy is a screening procedure used to detect colon cancer and remove any precancerous polyps in the colon. Most colon cancers arise from pre-existing precancerous polyps, so it is incredibly important to undergo regular colonoscopies to remove these polyps before they have a chance to become a colon cancer. Colon cancer can develop without any outward symptoms, highlighting the importance of getting regular colonoscopies. The process involves a small, tube-like instrument with a light and camera to examine the inside of your colon.

The colonoscopy exam involves some prep in the days leading up to the procedure, to ensure your colon is completely clear for the examination. Dr. Clayton Jordan, DO at The Iowa Clinic, notes that the prep and procedure itself isn’t as bad as people usually think it’s going to be.

“People hear a lot of rumors from neighbors and friends, but the procedure is extremely safe and the prep isn’t as bad as people think it will be. The preps have come a long way and for the most part people tolerate them very well now,” Dr. Jordan says.

Once you’ve scheduled a colonoscopy with your provider, the process is fairly straightforward.

Prep will include:

  • The day before the procedure patients will be on a clear liquid diet with the exception of a light breakfast (only option is one egg with a plain piece of toast or one banana with one cup of plain yogurt) that must be consumed before 10 am the day before the procedure, only for patients that don’t have chronic constipation.
  • The night before the procedure, over the course of about two hours, patients will drink half of the prep liquid.
  • The morning of the procedure, patients drink the remaining half of the prep over about two hours, finishing two hours before the procedure check-in is scheduled.
  • Because sedation is involved, patients scheduled for a colonoscopy must be dropped off and picked up by someone else.
  • After arriving for the procedure, patients will get checked in, change into a gown, and go over the full details of the procedure with their care provider.
  • The examination itself takes about 20-30 minutes and once complete, any immediate results are discussed with the patient and family.
  • Any tissue that was removed during the procedure then goes to the lab for further analysis to help determine when the next colonoscopy will be.

When Should I Start Having Colonoscopies?

The guidelines for when you should schedule your first colonoscopy have recently changed, Dr. Jordan says.

“Screening colonoscopies used to start at age 50, but now it’s recommended to start at age 45 for all patients. Increasing numbers of polyps and cancers are being found in younger patients, so starting these routine screenings earlier gives us a better chance at finding and removing precancerous polyps before they have a chance to become cancer,” Dr. Jordan says.

The exception to the age 45 screening rule (when you might need to have a colonoscopy even earlier) is if you have a heightened risk of developing colon cancer. These risk factors are often discovered through conversations about family history and are discussed separately below.

For patients with no family history or polyps, colonoscopies are repeated every 10 years. If polyps are discovered during your colonoscopy, you will work with your provider to determine the best screening interval. Depending on the number and type of polyps discovered, you may require a repeat colonoscopy at 1, 3, 5, or 7 years.

Patients who have a first degree relative who has had colon cancer or advanced adenomas (very large or advanced polyps), but don’t have any polyps themselves, should expect to have colonoscopies done every 5 years.

What are Risk Factors for Colon Cancer?

There is a genetic component to colon cancer. If you have a first degree relative (mother, father, sibling, or child) who has had colon cancer or an advanced adenoma, you are considered to be at a higher risk for developing precancerous polyps or colon cancer. In this situation, it’s recommended that you begin routine screening colonoscopies at age 40 or 10 years younger than the age at which the first degree relative was diagnosed.

Managing Routine Colonoscopy Screening Easily with Coordinated Care at The Iowa Clinic

Regardless of your personal history or individual risk factors, colonoscopy screening is an important part of colon cancer prevention and everyone’s health.

“Colon cancer is preventable in most situations by finding and removing precancerous polyps before they have a chance to become a cancer. Also, if you catch a colon cancer in the early stages, it can almost always be surgically cured. Once it has metastasized outside of the colon, it’s a very different conversation,” Dr. Jordan says.

Regular screening colonoscopies can help reduce the risk of death from colon cancer by as much as 75%. When there are incidences of colon cancer found, cancers found in the early stages are 90% treatable and most can be surgically cured.

If you have questions about your risk factors or believe it’s time to start scheduling colonoscopies, talk with your primary care provider. At The Iowa Clinic, coordinating your care from primary care to colonoscopies and beyond is easy and seamless.

“The Iowa Clinic is a multi-specialty group, so the process from primary care to subspecialists is smooth and well-coordinated. We all talk as colleagues, share information, and work hard to take the best care of our patients together. The open communication keeps everyone on the same page with the treatment plan,” Dr. Jordan says.

Ready to schedule your colonoscopy? Fill out the prep questionnaire or give us a call today.

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