Colonoscopy Age Recommendations

With Specific Details for People With a Family History of Colon Cancer

The U.S. Preventive Services Task Force (USPSTF) recommends regular colorectal screening for everyone starting at age 45. People at an increased risk for colorectal cancer should talk to their healthcare providers about early screening. Colorectal cancer affects people of any sex and is the third leading cause of cancer death. Screening can help identify colon cancer, even if you don't have symptoms.

This article will discuss the age at which you should schedule your first colonoscopy and overview the risk factors that may prompt early screening.

Healthcare provider discussing medical test results with patient using digital tablet

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When Should You Have a Colonoscopy?

You should schedule your first colonoscopy at age 45 and have them every 10 years after that until you reach age 75. Although there are various methods healthcare providers use to screen for colorectal cancer, a colonoscopy is considered the gold standard.

Screening vs. Diagnostic Testing

Screening aims to look for the disease before symptoms are present. Your healthcare provider may recommend a colonoscopy as a diagnostic test if you have abnormal results from a previous colorectal screening test or if you have specific symptoms.

Before 45 Years Old: Necessary or Not?

If you don't have risk factors requiring early screening, you should get your first colonoscopy at age 45. Your healthcare provider will consider the following to determine your risk:

  • Personal history of colorectal cancer, polyps, and radiation to the abdomen or pelvic area abdomen or pelvic area to treat a prior cancer
  • Family history of colorectal cancer
  • Personal histories of inflammatory bowel disease (IBD) like ulcerative colitis or Crohn's disease
  • Known or suspected genetic conditions like familial adenomatous polyposis or hereditary non-polyposis colon cancer

If you have any of the above conditions, you are at an increased or high risk for colorectal cancer. Talk to your healthcare provider about screening before age 45 to identify polyps or cancer.

After 70 Years Old: Necessary or Not?

The USPSTF does not recommend routine screenings for colorectal cancer in adults age 76 to 85. Your healthcare provider can make personalized recommendations for a colonoscopy by considering the following:

  • Personal preference
  • Life expectancy
  • Overall health
  • Prior colorectal screening history

Gender Recommendations for Colorectal Cancer Screening

Age is the most important consideration for colorectal cancer screening. It is recommended for men and women between the ages of 45 and 75.

Repeat Colonoscopy: How Often to Have One

You should have a colonoscopy every 10 years if you do not have an increased colorectal cancer risk. If you are at an increased or high risk for colorectal cancer, your provider may recommend more frequent screenings. The following describes the specific risk factors and the general recommended frequency for colonoscopy.

  • Family history of colon or rectal cancer: Will depend on who in the family had cancer and the age of their diagnosis
  • History of polyp removal: On average, every three years
  • Personal history of colon or rectal cancer: Regularly, as soon as one year after surgical cancer removal
  • Radiation to remove previous cancer: Five years after radiation or age 30 (whichever comes second) and every three to five years after that
  • People with inflammatory bowel disease (IBD): Eight years after IBD diagnosis for the first colonoscopy and every one to three years after that
  • Genetic risks: As early as the teenage years for the first colonoscopy and repeated more frequently than for those not of high risk

Costs and Insurance Coverage 

Many insurance plans cover screening tests. If you have insurance, you may be responsible for a co-payment or other associated costs, such as follow-up appointments or additional tests. Related expenses may vary, depending on the insurance carrier.

If you do not have insurance or an insurance plan does not cover the cost of colorectal screening, resources are available through local, county, or state health departments or by calling 800-CDC-INFO (800-232-4636).


Colorectal cancer is the third most common cancer in men and women. People with an average risk for colorectal cancer should get their first colonoscopy at age 45 and repeat screening every 10 years until age 75. A colonoscopy may be recommended earlier and more frequently for people with an increased or high risk. Talk to your healthcare provider about your risk factors and to schedule a colonoscopy.

A Word From Verywell

You may feel like there is never a good time for a colonoscopy. Still, the USPSTF says otherwise. Completing preventive health screenings, such as colonoscopies, can help reduce your risk of developing colon or rectal cancer in the future. Generally, cancers are easier to treat when found early. Colorectal cancer screenings can help ensure that you enjoy long-term health.

Frequently Asked Questions

  • What’s the ideal age to schedule a colonoscopy?

    According to the American Cancer Society, the recommended age for a colonoscopy is 45 years old for both men and women as long as the individual is considered of average risk. People with increased risk may need earlier and more frequent screenings.

  • Why would you need to have an early colonoscopy?

    You might need a colonoscopy before age 45 if you have a personal or family history of colorectal cancer, have had certain types of polyps removed, or have had radiation treatments to the abdomen or pelvis to treat previous cancer. People at high risk for colorectal cancer have a history of inflammatory bowel disease or certain genetic conditions and likely need an early colonoscopy.

  • Are there any risks of having a colonoscopy?

    The most common risks associated with colonoscopies include perforation (puncture) and gastrointestinal (GI) bleeding. These risks are rare, with perforation occurring in 4 of every 10,000 colonoscopies and GI bleeding in 8 of every 10,000.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. U.S. Preventive Services Task Force. Colorectal cancer: screening.

  2. Centers for Disease Control and Prevention. Colorectal cancer screening tests.

  3. American College of Gastroenterology. Clinical guidelines: colorectal cancer screening 2021.

  4. American Cancer Society. Get screened.

  5. American Cancer Society. Do I have colorectal cancer? Signs, symptoms and work-up.

  6. American Cancer Society. Guideline for colorectal cancer screening.

  7. American Cancer Society. American cancer society guideline for colorectal cancer screening.

  8. American Cancer Society, Costs and insurance coverage for cancer screening.

  9. Ko CW. Colonoscopy risks: what is known and what are the next stepsGastroenterology. 2018;154(3):473-475.

By Pamela Assid, DNP, RN
Pamela Assid, DNP, RN, is a board-certified nursing specialist with over 25 years of expertise in emergency, pediatric, and leadership roles.