How Often Should I Have a Colonoscopy?

The thought of scheduling a colonoscopy probably isn't high on anyone's to-do-list, but it's one of the most important screening tools we have. Unlike many screening tests that simply detect disease, a colonoscopy can actually prevent colon cancer by finding and removing polyps before they have a chance to become something more serious.

If you’ve ever wondered, “How often should I have a colonoscopy?” the answer isn’t the same for everyone. It depends on several factors, including your age, your personal health history, and whether colon cancer or polyps run in your family.

What is a Colonoscopy and Why is it Necessary?

A colonoscopy is a procedure in which a gastroenterologist uses a long, flexible tube with a small camera, called a colonoscope to look at the lining of the colon and rectum. It’s considered the gold standard for colon cancer screening because it allows doctors to both see potential issues and take action immediately, such as colon polyp removal.

During the colonoscopy procedure, if the doctor finds a growth or polyp, it can often be removed right away. This ability to spot and address problems at the same time is what makes a colonoscopy a preventive, potentially life-saving test rather than just a diagnostic care.

Colonoscopy Age: When to Start Your First Screening

In recent years, the medical community has moved the starting line for colon cancer screening. While age 50 was once the standard, the American Cancer Society and the U.S. Preventive Services Task Force now recommend that adults at average risk begin screening at age 45.

This shift comes in response to a rise in colorectal cancer cases among younger adults. Whether you’re considering a colonoscopy for women or a colonoscopy for men, 45 is now the point when it makes sense to start the conversation with your healthcare provider.

Determining Your Screening Frequency and Risk Level

How often you’ll need a colonoscopy really comes down to your personal risk level.

1. Average Risk (Every 10 Years)

If you are between the ages of 45 and 75, have no symptoms, no history of polyps, and no family history of colorectal cancer, you are considered "average risk." In that case, a colonoscopy is usually recommended just once every 10 years.

2. History of Polyps (Every 3 to 7 Years)

If a previous exam involved colon polyp removal, you’ll likely need another screening sooner. The exact timing—often 3, 5, or 7 years based on:

The number of polyps found.

The size of the polyps.
The specific tissue type (pathology) of the polyps.

3. High Risk (More Frequent Screenings)

Some people need colonoscopies more often—sometimes every year or every two years.You may be in the high-risk category if you have:

Inflammatory Bowel Disease: Conditions like a Crohn's disease colonoscopy or an ulcerative colitis colonoscopy are necessary to monitor chronic inflammation.

Family History: If a first-degree relative had colorectal cancer.
Genetic Syndromes: Such as Lynch syndrome or Familial Adenomatous Polyposis (FAP).

Preparing for the Procedure: Colonoscopy Prep Instructions

Most people will tell you that the colonoscopy prep is the most challenging part of the process, but it's also one of the most important. A clean colon gives your doctor a clear view which means more accurate results.

Bowel Prep for Colonoscopy: You will be prescribed a colonoscopy prep drink such as Suprep bowel kit, designed to fully clear your system before the procedure.
The Diet: You’ll also follow specific colonoscopy prep instructions, which usually means starting with a low fiber diet for colonoscopy several days prior, then switching to a clear liquid diet for colonoscopy the day before.
Five-Day Rule: A common question is what you should avoid eating 5 days before a colonoscopy? Generally, it's best to stay away from heavy, hard-to-digest foods like nuts, seeds, popcorn, and whole grains, as these can linger in the colon.

Endoscopy vs Colonoscopy: Understanding the Differences

When you’re searching for a colonoscopy near you, it’s common to see the term endoscopy mentioned as well. While both procedures use a camera to look inside the body, they focus on different areas of the digestive tract.

Colonoscopy: A colonoscopy examines the lower GI tract including the colon and rectum.
Endoscopy (Upper): an upper endoscopy also known as an EGD, this examines the upper GI tract specifically the esophagus, stomach, and duodenum.

In some cases, a doctor may recommend both procedures if someone is dealing with broader digestive issues. However, when it comes to colon cancer screening, a colonoscopy is the primary and most effective tool.

Understanding the right age for colonoscopy and your specific risk factors is vital for colonoscopy and colorectal cancer prevention. Whether you’re scheduling your first screening at 45 or coming in for routine follow-up due to ulcerative colitis, staying on track with recommended screenings is one of the best steps you can take for your long-term health.

FAQs:

1. How long does a colonoscopy take?

The actual colonoscopy procedure usually takes between 30 and 60 minutes. However, you should plan to be at the facility for about 2 to 3 hours to account for check-in, sedation prep, and recovery.

2. What can you not eat 5 days before a colonoscopy?

Avoid high-fiber foods such as raw vegetables with skins, beans, tough meats, and any bread or cereal containing seeds or nuts. These can stay in the digestive tract and obscure the doctor's view.

3. What to eat after colonoscopy?

After the procedure, you should start with small, light meals. Think easy-to-digest foods like soups, crackers, eggs, or white toast. Avoid greasy or extremely spicy foods for at least 24 hours as your digestive system wakes up from sedation.

4. How many polyps are normal in a colonoscopy?

There is no "normal" number, but it is very common to find one or two. The goal of the procedure is colon polyp removal regardless of the number, as removing them eliminates their potential to become cancerous.

5. Does the procedure feel different for men and women?

While the equipment is the same, a female colonoscopy procedure can sometimes be slightly more complex if the patient has had abdominal surgeries like a hysterectomy or C-section, which can create scar tissue. However, for the patient, the experience under sedation remains the same.

Published on 03 Feb, 2026