45 Or Older? It’s Time to Screen For Colon Cancer

I never got to meet my maternal grandmother — she died from colon cancer a few years before my birth.

I look like her and am told that our personalities are quite similar, which is a blessing. But there’s a caveat to being her granddaughter, and that’s a higher risk of getting colon cancer. 

Because of this genetic predisposition, my mom has been getting colonoscopies far before the typically recommended age of 50. 

In recent years, there has been an uptick in younger people getting the disease, so the recommended first screening guidance has been changed from age 50 to 45. 

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So that means I had my first colonoscopy this year, and hoo boy, I could TMI you, dear readers, but I won’t. 

You’ll get to experience it firsthand one day and I don’t want to spoil the surprise. There may be more than one surprise!


Colonoscopy Preparation & Test

Seriously, a colonoscopy is not a painful experience by any means. You’re mostly asleep — I was under what’s called twilight or conscious sedation, but remembered nothing. 

If you’re lucky (or unlucky, depending on how you behaved), a nurse will tell you what you said during the test. 

In my case, I said “Why can I hear lightsabers” and when the doctor asked me if I wanted to look at the monitor to see what was going on, I politely declined by saying “No thank you, I do not want to see the inside of my butthole.”

You’re sleepy after the procedure, but I felt fine — the worst part was the test prep. 

Preparation for a colonoscopy includes drinking what seems like gallons (it’s not, I’m dramatic) of a pre-made solution that helps clean you out, followed by an enema. 

You’re on the toilet for a majority of the eve of the test, but hey, think of it as a bonus cleanse!

And there have been so many advances in screening for colon cancer, you may not need to have a traditional colonoscopy at 45 — there are other options available (although it is recommended to have one at 50). 

What Is Colon Cancer?

Colon cancer is a type of cancer that begins in the large intestine, the colon, which is the final part of the digestive tract.

“Colon cancer typically affects older adults, though it can happen at any age. It usually begins as small, noncancerous (benign) clumps of cells called polyps that form on the inside of the colon. Over time some of these polyps can become colon cancers,” according to the Mayo Clinic. 

“Polyps may be small and produce few, if any, symptoms. For this reason, doctors recommend regular screening tests to help prevent colon cancer by identifying and removing polyps before they turn into cancer.”

Colorectal Screening 

As we said above, doctors recommend that people with an average risk of colon cancer should consider colon cancer screening around age 50, but the guidelines have been changed to age 45 due to an increase in colon cancer cases. 

People with an increased risk, such as those with a family history of colon cancer, IBS (Irritable Bowel Syndrome), or Crohn’s Disease should consider screening earlier.

Several screening options exist — each with its own benefits and drawbacks. Talk about your screening options with your doctor, and you can decide which test is right for you.

Screening Options 

If you are at low risk for colon cancer, you can do an at-home stool test — a FIT (fecal immunochemical test). 

Your doctor will give you a kit, there is no prep, and you’ll have to mail the stool sample to a lab. 

And that’s it! However, if the lab finds blood in the sample, you will need to get a colonoscopy. 

A FIT is recommended every year. 

Traditional Colonoscopy 

A colonoscopy is “The endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus,” in doctor speak. 

In layman’s terms, they put a camera into your bum and take pics of what’s going on in there. 

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The benefits of a traditional colonoscopy are: 

  • You only have to get one every ten years.

  • You will be asleep during the procedure.

  • Any abnormal tissue (polyps) can be removed during the procedure.

  • The screening does not take a long time.

  • Due to the medications that make you comfortable during the exam, you will need to take the day off from work and have someone drive you home.

Virtual Colonoscopy

This is a non-invasive alternative to colonoscopy used to screen for colorectal cancers.

The virtual option does involve a similar prep as a traditional colonoscopy. Both procedures require a clean colon, meaning only clear liquids and a laxative solution the day before.

Virtual colonoscopy (VC) uses X-rays and computers to produce three-dimensional images of the rectum and then displays these images on a screen. 

Since sedation is not used for virtual colonoscopies, patients can go home after the procedure without the aid of another person and can return to their usual activities right away. 

This test is recommended every 5 years as opposed to the 10 with a traditional colonoscopy. 


An ultrasound is a test that uses sound waves to evaluate if cancer is present, the depth of cancer and to determine if it has spread to lymph nodes. 

There are both endoscopic ultrasound (EUS) and 3D transrectal ultrasound (TRUS). 

During these procedures, a physician uses a special ultrasound probe to capture images or take tissue samples.

Probe-Based Confocal Laser Endomicroscopy (pCLE)

This test is a precise technique for viewing tissue cells in the digestive tract at a cellular level. 

Using one of the world’s smallest microscopes, physicians are able to detect and remove cancerous tissue during a single procedure. In some cases, doctors may send a patient immediately to surgery.

Colon Capsule Endoscopy (ScotCap Test)

The ScotCap Test is a new procedure — a colon capsule endoscopy — which is being introduced and used as an alternative to a colonoscopy. 

Your doctor will decide if it’s appropriate for you, depending on your symptoms and previous tests.

A colon capsule endoscopy is a painless procedure that uses a camera to examine the large bowel (colon). Your bowel takes away the waste your body does not need.

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“The ScotCap Test is a capsule that you swallow, and it contains two tiny cameras inside. The cameras take pictures of the lining of the bowel to look for any problems or signs of disease. This test can be used instead of a colonoscopy,” says the NHS. 

There is laxative prep for this test — your bowel needs to be clean, like with a traditional colonoscopy. 

“For this test to work well your bowel needs to be very clean so the cameras get the best pictures. For a few days before your test, you will be asked to change your diet, and to have only the type of food and drinks which help soften your stools.”

They’ll fit you with a special belt and receiver which you can wear underneath your clothes, and you’re given the capsule to swallow. The receiver captures the pictures of your bowel which are sent wirelessly from the capsule. 

“You wear the belt and receiver at home during the whole test which on average lasts 6 hours, in some cases up to your bedtime. Throughout the day of your test you’ll be asked to take more laxatives which act as a “booster” to help move the capsule through your bowel,” says the NHS. 

colonoscopy alternatives

The capsule will pass out of your bowel in the evening and you can remove the belt and receiver. 

The day after the test you return the belt and receiver and the pictures from your test are uploaded from your recorder once it is returned. The pictures are then made into a video which is reviewed by your doctor.

Which Colonoscopy Alternatives Are Best For You?

Thanks to medical advances, you and your keister have many options when it comes to colorectal cancer screening. 

colonoscopy alternatives

Talk to your doctor about which course of action is best for you and your physical health — and get screened when you hit 45. 


Were you aware they lowered the age of screening for colon cancer? Do any of these colonoscopy alternatives look preferable to the traditional test? Let us know in the comments! 

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