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I know you may be distrustful of invasive procedures—whether it’s major surgery or a routine biopsy. And for the most part, I agree with you. 

However, there are some exceptions to that rule.  

For me, personally, the exception is colonoscopies. (I lost my father and two uncles to colon cancer.) And I advise all of my patients to at least consider the procedure. Especially because this is one case where screening sooner is actually better.  

And yes—that screen could save your life.   

In fact, the latest research has shown that polyp and adenoma detection is twice as high when you start getting colonoscopies at age 45, rather than waiting until 50. And that’s true for patients both with and without personal and family history of polyps and colon cancer.   

Why earlier is better 

This study reviewed the results of more than 6,000 colonoscopies. The average age of patients was 57 years, and just over half were female.  

Here’s a breakdown of the findings:  

  • Polyps were detected at a rate of 34 percent  
  • Larger polyps (bigger than 1 centimeter) were found at a rate of 8 percent  
  • Adenomas (non-cancerous tumors) were detected at a rate of 32 percent 
  • Neoplasia (abnormal growth of tissue) were detected at a rate of 3.6 percent 

But here’s the juicy bit: When researchers broke down the results into five-year increments, they found that detection rates stayed low until patients hit the age of 45. After that, they spiked dramatically. (Not exactly what you might expect!) 

In fact, among patients over 50, colonoscopy screening detected the following: 

  • Polyps were found at a rate that exceeded 35 percent 
  • Neoplasia was discovered at a rate that exceeded 5 percent. 

And for the patients between the ages of 45 and 49, polyp detection was also surprisingly high: 

  • Polyps were detected at a rate of 26 percent.  
  • Neoplasia was found nearly 4 percent of the time.  

And this is in patients without a family history. 

Get smart with screening  

Clearly, colorectal cancer is on the rise among younger patients. Researchers are baffled as to why—but I have a few guesses. Like our increasingly abysmal eating habits, our love affair with carbohydrates, the chemicals in our food supply, chronic sleep loss, and excessive stress.  

But ultimately, it doesn’t really matter how many causes we’re able to identify if screening guidelines aren’t adjusted to reflect this new normal 

Because the fact is, many doctors live and die by official guidelines. And if those guidelines aren’t up to date, missed disease due to inadequate screening is only one of many dire consequences patients will inevitably suffer.   

Currently, the United States Preventative Services Task Force (USPSTF) recommends colon cancer screening for adults between the ages of 50 to 75 years. So, my advice to you is this… 

Find a doctor who’s committed to screening and treating you appropriately, rather than following insufficient guidelines that favor Big Insurance over a duty to public health. If you’re 45 and haven’t been screened, go immediately. 

And I get it, some squeamishness toward the procedure is totally understandable. But nowadays, there are less invasive tests that may eventually take the place of routine colonoscopies. So I hope you’ll at least consider one type of screen.   

The test that I’m most familiar with is called Cologuard. It’s approved by most insurance companies. But if you do have to pay for it, the cost is around $500. 

That’s not exactly cheap, but it is a whole lot cheaper than colon cancer, in just about every imaginable way. 


“Start Colon Cancer Screening at Age 45, Evidence Suggests.” Medscape Medical News, 10/30/2017. (