Fight colorectal cancer; get screened

By John Choi, MD  |  2/27/2020

Most people should have their first colonoscopy at age 45, to look for polyps, which are abnormal tissue growths. Polyps can be cancerous or become cancerous, depending on what type they are, but they tend to not cause any symptoms in the early stage of disease. Early detection through screening is key.

Fifty used to be the magic birthday; however, the screening guidelines were recently changed and now its recommended people get tested before their half-century milestone.

Certain people should have a colonoscopy earlier and more frequently than average-risk individuals, and you should know if you fall into that category. Genes are the determining factor and could put you at higher risk. It’s worth a conversation with your family to know if that’s you.

For example, if your mom, dad, brother or sister were diagnosed with the worrisome type of polyps called adenomas or if they had colorectal cancer before age 60, you should have your first colonoscopy at age 40 and continue them every five years.

The same rule applies if two of your relatives such as your grandparents, aunts or uncles were diagnosed.

If any close relatives were diagnosed with colorectal cancer in their 20s, 30s or 40s, you should start your screenings 10 years before the age of your youngest affected relative. For example, if your mom was diagnosed at 61, and your aunt was diagnosed at age 47, you should be screened at age 37.

When you have your annual physical with a primary care provider, make sure to discuss your family’s colorectal cancer history.

There’s another category of higher risk people. Familial adenomatous polyposis (FAP) is a genetic condition and is diagnosed when a person — usually in their mid-teens — develops more than 100 precancerous polyps. The condition is usually found when the child or teenager has rectal bleeding, sudden bowel habit changes, abdominal pain, low blood counts or unexplained weight loss. Once diagnosed with FAP, genetic testing, genetic counseling and an annual screening by sigmoidoscopy — a “mini colonoscopy” of just the rectum and lower colon — is recommended.

Someone with hereditary nonpolyposis colorectal cancer, or “family cancer syndrome,” should be referred for genetic testing, genetic counseling and a colonoscopy every one to two years beginning at age 20 to 25, or 10 years younger than youngest age of colorectal cancer diagnosis in family.

There are additional signs and symptoms of colon trouble you shouldn’t ignore. Anyone with the following symptoms should talk to their doctor right away: bloody stools, unexplained diarrhea, long bouts of constipation, stomach cramps, change in bowel habits, frequent gas or bloating, unexplained weight loss or vomiting with exhaustion.

In summary, colonoscopies are important preventive screenings. Speak to your families, know your risks and talk to your medical providers about your thoughts and concerns regarding your health.

Dr. John Choi is a colorectal surgeon with Health Quest Medical Practice on the medical staff of Vassar Brothers Medical Center. To learn more about the practice and providers, visit