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Cancer Screening

Think You Don’t Need a Colonoscopy? Think Again

By on 03/11/2021

When “Black Panther” star Chadwick Boseman died of colon cancer this past year, many Americans were shocked. After all, the 43-year-old actor was far too young to develop the disease, wasn’t he?

In fact, Boseman was just one of thousands of younger people diagnosed with colon cancer in the U.S. every year. Colorectal cancer is the leading cause of cancer deaths in people under 50, according to the National Cancer Institute.

Fortunately, minimally invasive screening tests can help doctors find cancerous or pre-cancerous growths in the colon long before any symptoms appear. That likely wouldn’t have helped Boseman, who was diagnosed before the age where routine screenings are recommended, but it is one of the reasons the recommended age for beginning routine colonoscopies has been lowered in recent years.

Why Are Colonoscopies So Important?

While fewer older Americans are dying of colorectal cancer, thanks in part to the availability of screening colonoscopies, younger people aren’t quite so lucky. The colon cancer rate in younger people has more than doubled in the last 30 years, according to the NCI. This prompted the American Cancer Society® to lower its recommendation for getting your first colonoscopy from age 50 to 45 in 2018. The U.S. Preventive Services Task Force followed suit in late 2020 by also recommending that guidelines be updated to lower the suggested age of first colonoscopies to 45.

Colon cancer rarely causes symptoms at first. You may feel perfectly fine even as cancerous cells begin to attack the lining of your rectum or large intestine (colon). By the time you begin to experience changes in bowel habits, abdominal pain, bleeding or any other symptoms, the cancer may be quite advanced.

Lowering the age of first colonoscopies offers these important benefits:

  • Identification of pre-cancerous polyps: During a colonoscopy, your doctor may remove small growths called polyps that grow in the lining of the rectum or colon. Polyps can be benign (non-cancerous), pre-cancerous or cancerous. Removing benign and pre-cancerous polyps prevents the growths from ever becoming cancerous. This lowers your risk of developing colorectal cancer.
  • Earlier cancer detection: The sooner cancer is diagnosed, the better the outcome. Diagnosing and treating colon cancer early prevents it from spreading and allows less invasive treatments to be used. It also increases the survival rate.

How Do Colonoscopies Work?

Colonoscopies allow your doctor to view the lining of your rectum and colon without performing surgery. Your doctor inserts a thin, flexible probe into your rectum during the procedure, then slowly passes it through your large intestine. A miniature camera attached to the end of the probe sends images to a digital monitor.

During a colonoscopy, doctors look for lesions, bleeding areas, polyps and changes in the lining of the rectum and colon. If your doctor spots a polyp, he or she will remove it and send it to a laboratory for testing. Samples of lesions or bleeding tissue may also be removed for analysis.

If your colonoscopy doesn’t reveal any issues, you won’t need another test for 10 years. If a polyp or other concerning change is discovered, you may be instructed to repeat colonoscopies more often, such as every 3 or 5 years.

Are You at Risk for Colorectal Cancer?

Although anyone can get colorectal cancer at any age, you may be more likely to develop the disease if you:

  • Smoke
  • Use alcohol excessively
  • Eat a high-fat, low-fiber diet
  • Are overweight
  • Don’t get enough exercise
  • Have an inflammatory bowel disease or a family history of colon cancer
  • Have had polyps in the past

Scheduling a colonoscopy is a simple way to protect your health. If you’re 45 or older and haven’t yet had a colonoscopy, consider adding this valuable screening test to your calendar this year. If you have certain risk factors or you have any possible symptoms of colorectal cancer, your doctor may recommend you begin screenings at a younger age.


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Date Last Reviewed: January 11, 2021

Editorial Review: Andrea Cohen, Editorial Director, Baldwin Publishing, Inc. Contact Editor

Medical Review: Perry Pitkow, MD

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Perspectives highlights the expertise and services provided by the physicians, specialists, nurses and other healthcare providers at Einstein Healthcare Network. Through this blog, we share information about new treatments and technologies, top-tier clinical teams and the day-to-day interactions that reinforce our commitment to delivering quality care with compassion. Here, you will also find practical advice for championing your health and wellness. The Einstein Healthcare Network "Terms of Use" apply to all content on this blog.