How Often Do You Need a Colonoscopy?

Just so everyone understands, this is not the question I bring up at dinner time to spark conversation.

According to the American Cancer Society, people with an average risk of colon cancer should receive screening about once every 10 years starting at age 45. They moved it down from starting at 50 in 2018.

Between 76 and 85, it’s up to you. And as I wrote in a previous email a while ago, my mother who is in her 80’s had a doctor recommend one, despite other doctors saying she didn’t need it. The result? She had colon cancer. Thank God for that doctor. Fortunately they caught it very early and she is doing great.

If you’re in a higher risk group, such as having a history of polyps or a family history, you’ll want to be screened more often.

So that’s the current guidance.

Although a new study has found you might not need so many screenings after all. The study looked at 195,453 individuals who participated in the Nurse’s Health Study, the Nurse’s Health Study II and the Health Professionals Follow Up Study from 1991 to 2020.

The Nurses Health Study looked at women over the time period and the Health Professionals Study looked at men.

Now I’m always skeptical about studies that last many years. It means they are having the participants fill out questionnaires on what they ate and the lifestyles they lead. Some problems with this include:

1. Do you remember what you ate the last couple of days (excluding you carnivore people who can probably guess pretty accurately)?

2. Do you think people who eat unhealthy foods might want to embellish the truth a little?

Nevertheless the results of the study suggest colonoscopies and other colon cancer screening may not be needed quite as much as we thought.

The researchers came to the conclusion that if you have a completely negative result of your initial screening, meaning no polyps of other causes for concern, you could go 20 years without another screening.

This study caught my attention a bit because normally studies recommend more big-business interventions.

More tests.

More drugs.

More follow-ups.

This one was less.

Another interesting aspect of the study was the division of the participant groups into low, medium and high-risk groups. The risk level refers to the individuals lifestyle.

As you would imagine, people who ate very nutritious meals, exercised regularly, didn’t smoke, weren’t obese, yada, yada, yada, were in the low-risk group.

Those that did the opposite were in the high-risk group.

Therein lies the problem. The colonoscopy study is all about the frequency of testing. They just mention which ‘risk group’ did the best without elaboration. You have to dig into the demographic underlying studies to find out the definition of the risk groups.  It seems instead this would be a perfect opportunity to put in the conclusion:

“Don’t worry so much about the frequency of the tests. Worry about what you are doing to your darn body.”