At What Age Should You Stop Getting Screening Colonoscopies?
Key takeaways:
Colonoscopies can find colorectal cancer early, when it’s easier to treat. Most people should have a colonoscopy every 10 years starting at age 45.
You’re never “too old” for a colonoscopy. But people over 85 years old need to consider the risks and benefits of screening colonoscopies.
The colonoscopy procedure can be risky for older adults and those with certain medical conditions. You should consider your personal risk factors for colorectal cancer and your overall health, in addition to your age, to help you decide how long to continue screening.
Table of contents
Most people should start colorectal cancer screening with a colonoscopy at age 45. People at higher risk for developing colorectal cancer may need screening colonoscopies earlier. There are clear benefits to screening colonoscopies, like helping to prevent cancer diagnosis at an advanced stage.
Most experts agree on when people should start getting screening colonoscopies. But there is not a consensus on what age to stop. If you’re wondering whether you really need that next colonoscopy, here’s what you need to know about the risks and benefits of a colonoscopy as you get older.
What age should you stop getting colonoscopies?
There’s no hard rule. In the past, 75 years old was considered the age at which you could stop colonoscopies. But new research shows that people between the ages of 75 and 85 may still benefit from colonoscopy screening.
So, the decision to continue or stop screening colonoscopies is an individual one. It’s based on:
Your personal risk of developing colorectal cancer
Your overall health
The risks of the colonoscopy procedure
Why it matters: Routine screenings for colorectal cancer can help catch the disease early. One man shares what he learned about the importance of colonoscopies after his sister died from rectal cancer at age 56.
What to expect: Colonoscopies may seem uncomfortable — but they help safeguard your future health. Three people share their experiences with the procedure.
What they cost: Most insurance plans cover colonoscopies, but you might have some out-of-pocket costs. Here’s what you can expect to pay, and what factors might affect the price.
Why is there a colonoscopy age limit?
At some point, the risk of a colonoscopy outweighs the benefit of detecting colorectal cancer early. That’s why there’s an age limit. This is mostly based on any medical conditions you may have and if you’re at average risk for colorectal cancer.
For example, if you are at average risk and have medical conditions that increase your risk for bleeding or limit your ability to receive anesthesia, then a colonoscopy may not be worth the risk.
But if you don’t have any major medical problems and you’re at average risk, then a screening colonoscopy may be worthwhile, no matter how old you are.
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Your healthcare provider can help you understand these risks and benefits, so you can make the decision that feels right for you.
It also helps to take into account your personal screening history. If you’ve never been screened for colorectal cancer and you are over age 75 and in good health, a colonoscopy may be a good idea. But if you’ve been screened multiple times and never had concerning findings, your risk of colorectal cancer may be small, and you may not need further screening.
Age really is just a number. And, while it’s an important detail to consider, it should not be the only factor in your decision about when to stop getting colonoscopies.
What are the benefits of a colonoscopy?
Screening colonoscopies can detect colorectal cancer early, when it’s easier to treat. Colonoscopies can also detect colon polyps. Colon polyps can develop into colon cancer. Your healthcare provider can remove colon polyps during your colonoscopy, before they have a chance to develop into cancer.
But a colonoscopy is a medical procedure. And it requires anesthesia. All medical procedures and medications for anesthesia come with risks. As you get older, these risks need to be carefully balanced against the benefits of detecting cancer or polyps early.
Colonoscopy risks for older adults
The following are the most serious complications associated with a colonoscopy:
Colon perforation: when the scope pokes a hole in the intestine
Bleeding: can happen from the scope itself or from biopsy or polyp removal
Infection: can occur if bacteria from the intestine gets into the bloodstream
Heart or breathing problems: can result from the anesthesia medications
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Studies show that these complications are rare but slightly more common in people who are older. These complications can sometimes lead to serious illness, permanent disability, or death. These are important risks to consider, given that a colonoscopy is an elective procedure.
Preparing for a colonoscopy is also difficult. It involves fasting and drinking a bowel preparation solution that causes frequent, loose stools. The goal of the preparation process is to clean out the colon before the procedure. But it can also lead to complications, which include:
Dangerous imbalances of electrolyte levels due to diarrhea
Nausea and vomiting
Dizziness and weakness, due to dehydration and fasting, which can result in falls
The good news is that most people in good overall health are unlikely to have serious complications during the preparation process and procedure.
What research says about colonoscopy screening age
Research on colorectal cancer screening for adults over the age of 75 is still ongoing. Many older studies that looked into the benefits of colonoscopy only included people younger than 75. But there are several recent studies that looked at older populations.
In one study of people aged 75 and older, researchers found that screening colonoscopy helped to decrease the risk of colorectal cancer diagnosis and death by about 40%. But the study also reported that older adults with serious medical conditions were at higher risk of complications from the procedure.
A study of people 70 to 79 years old also found that colonoscopies helped to prevent cancer. But again, the researchers found that the older participants in the group (over the age of 75) had a slightly higher risk of complications from the procedure.
The takeaway here is that older individuals should evaluate their personal risk of complications before having a colonoscopy.
But how do you know when your age or medical conditions begin to increase your risk to a concerning level? Researchers developed a model that takes into account an individual’s personal risk factors for colorectal cancer in addition to their age. This model is helpful in evaluating the risks and benefits of a colonoscopy for a particular individual. It also shows that certain people may continue to benefit from screening into their late eighties and early nineties. This means that age is not the only factor in the decision to screen.
The bottom line
Experts agree that most people — especially those over the age 75 — should consider their risk factors and personal medical history when deciding to undergo screening for colorectal cancer. Colonoscopy is an effective tool that can help to prevent advanced colorectal cancer. But the risks of the procedure should not outweigh the potential benefits. Your healthcare provider can help you decide at what age you should stop getting a colonoscopy. Some healthy adults benefit from screening into their late eighties and early nineties.
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References
American Cancer Society. (2023). Colorectal cancer risk factors.
Ben-Ari, E. (2021). Should people over age 75 be screened for colorectal cancer? National Cancer Institute.
Cha, J. M., et al. (2016). Risks and benefits of colonoscopy in patients 90 years or older, compared with younger patients. Clinical Gastroenterology and Hepatology.
García-Albéniz, X., et al. (2017). Effectiveness of screening colonoscopy to prevent colorectal cancer among Medicare beneficiaries aged 70 to 79 years: A prospective observational study. Annals of Internal Medicine.
Kim, S. Y., et al. (2019). Adverse events related to colonoscopy: Global trends and future challenges. World Journal of Gastroenterology.
U.S. Preventive Services Task Force. (2021). Colorectal cancer: Screening.
Van Hees, F., et al. (2015). Personalizing colonoscopy screening for elderly individuals by screening history, cancer risk, and comorbidity status could increase cost effectiveness. Gastroenterology.
