You should start getting colonoscopies at age 45 if you are at average risk for colorectal cancer. This is based on updated recommendations by the American Cancer Society and the U.S. Preventive Services Task Force, which lowered the previous starting age of 50 to 45 due to increasing rates of colorectal cancer in younger adults. For people with higher risk factors—such as a family history of colorectal cancer, certain genetic syndromes, previous polyps, inflammatory bowel disease, or prior abdominal radiation—screening may need to start earlier, sometimes as early as age 10 to 12 for genetic conditions, or 40 years old or earlier depending on the family history. The frequency of colonoscopies may also vary according to these risk factors and medical history. To summarize:
- Average risk: start screening at age 45
- Higher risk due to family history or medical conditions: start earlier, often recommended around age 40 or 10 years before a relative's diagnosis
- Inflammatory bowel disease, genetic syndromes, previous polyps, or cancer history: need individualized screening schedules, potentially much earlier and more frequent screenings.
