You should usually get your first colonoscopy at age 45 if you’re at average risk for colorectal (colon) cancer, and earlier if you have certain risk factors like family history or genetic conditions.

When Should You Get Your First Colonoscopy? (Quick Scoop)

Colonoscopy timing has changed in recent years, especially with more colon cancer being found in younger adults.

Standard recommendation (average-risk adults)

For people with no special risk factors :

  • Most major guidelines now say:
    • Start screening at age 45.
* If the colonoscopy is normal, repeat about **every 10 years** until around age 75, as long as you’re in good health.
  • “Average risk” usually means:
    • No personal history of colon or rectal cancer.
    • No prior advanced polyps.
    • No inflammatory bowel disease affecting the colon (like long‑standing Crohn’s colitis or ulcerative colitis).
    • No known high‑risk genetic syndrome (like Lynch syndrome or FAP).
    • No first‑degree relative (parent, sibling, child) with colorectal cancer diagnosed young.

These changes (age 50 → age 45) were made because colon cancer is increasing in people under 50 , even while overall deaths have declined thanks to screening.

When you should go earlier than 45

Some people should not wait until 45. You may need your first colonoscopy earlier if:

  • Close family history of colorectal cancer or advanced polyps
    • If a parent, sibling, or child had colorectal cancer before 50, many experts advise:
      • Start at age 40 or 10 years earlier than the age your relative was diagnosed, whichever comes first.
  * Example: If your parent was diagnosed at 42, you might start at 32.
  • High‑risk genetic syndromes
    • Conditions like Lynch syndrome (HNPCC) or familial adenomatous polyposis (FAP) carry a strongly increased risk.
    • People with these may start screening much earlier , sometimes in their teens , and have colonoscopies every 1–2 years.
  • Inflammatory bowel disease involving the colon
    • Long‑standing ulcerative colitis or Crohn’s disease affecting the colon usually means:
      • Start colonoscopy about 8 years after diagnosis , then repeat every 1–3 years depending on findings.
  • Past abdominal or pelvic radiation
    • If you had radiation that exposed your colon, some guidance suggests starting 10 years after radiation or by about age 35 , whichever is later, with more frequent checks.

If any of these apply, the exact timing and interval should be personalized by a gastroenterologist.

How often do you need colonoscopies?

The follow‑up schedule depends on what your colonoscopy shows and your risk level:

  • Average risk, normal colonoscopy
    • Next colonoscopy in about 10 years.
  • Small, low‑risk polyps found
    • Often repeated in 7–10 years , depending on the number and type.
  • Higher‑risk findings or strong risk factors
    • May be repeated in 1–5 years , especially with:
      • Multiple or large polyps.
      • Certain precancerous changes.
      • Strong family history or a genetic condition.

Your doctor will usually give you a clear written interval after the exam.

Signs you shouldn’t wait for “screening age”

Regardless of age, you should talk to a doctor (and often need a colonoscopy or another test) if you have:

  • Rectal bleeding or blood in the stool.
  • Persistent change in bowel habits (new diarrhea, constipation, or narrowing of stool).
  • Unexplained weight loss, fatigue, or iron‑deficiency anemia.
  • Ongoing abdominal pain or cramping without a clear cause.

These symptoms do not always mean cancer , but they are important enough that many clinicians will investigate rather than wait for routine screening age.

Why this is a trending topic now

  • In recent years , medical groups and cancer centers report rising colorectal cancer in adults in their 20s–40s , which pushed the shift to start screening at 45 instead of 50.
  • Public campaigns, especially around Colon Cancer Awareness Month, emphasize:
    • Don’t skip or delay your first colonoscopy.
    • Ask your doctor if your family history or genetic risk means starting earlier.

You’ll also see many forum and social media discussions where people share nervousness about the prep but relief after finding and removing polyps early.

Mini FAQ

Is 50 too late to start?

  • If you’re already 50+ and never screened, it’s still absolutely worthwhile to start now. Screening is recommended up to at least age 75 for most adults in good health.

Can I use at‑home stool tests instead?

  • For some average‑risk people, stool‑based tests are an option, but a positive result usually means you’ll still need a colonoscopy.

Do women and men start at the same age?

  • Yes. Current guidance recommends both women and men at average risk start at 45.

Bottom line

  • Average risk: First colonoscopy at 45 , then typically every 10 years if normal.
  • Higher risk (family history, genetics, IBD, prior radiation): You may need to start earlier and go more often —sometimes as early as your 30s, or even younger in genetic syndromes.

Always confirm timing with your own doctor, who can factor in your age, family history, medical problems, and any symptoms.

Information gathered from public forums or data available on the internet and portrayed here.