What age should you get a colonoscopy with family history

04/08/2019

Table of Contents Show

Your Colonoscopy Schedule
When Should You Get a Colonoscopy If You Have a Family History?
What If They Find Something?
More Advanced Treatment
Screening options
Screening recommendations for those with a family history
Genetic counseling
How often should you have a colonoscopy with a family history?
What is considered a family history of colon cancer?
Is family history of colon polyps high risk?
What are the chances of getting colon cancer if it runs in your family?

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Everyone needs to undergo a colon cancer screening at some point in their life — and almost everyone finds a reason to put it off. Some people do it because they're worried that it will be an uncomfortable experience (the truth is that colonoscopies are not nearly as bad as you probably think, and alternatives exist). Other people are afraid of what the doctor might find.

With colon cancer diagnoses under age 50 on the rise, it's more important than ever to address your concerns and get your screenings on time. Colon cancer can be one of the easiest cancers to treat, as long as it's discovered early enough.

Your Colonoscopy Schedule

No matter what, you should plan to get your first colon cancer screening at age 45 or earlier. The American Cancer Society recommends that people without any risk factors start screening at that age, and people in good health should receive a screening every 10 years. Colonoscopies are the preferred screening method, and doctors also recommend virtual colonoscopies every five years.

Healthy people without risk factors should stay on the 10-year schedule of colonoscopies until age 75. After that, colonoscopies should be scheduled according to the patients' preferences and medical needs, stopping at age 85. Your doctor can help you put together a colonoscopy schedule that's tailored to your unique medical history and needs.

When Should You Get a Colonoscopy If You Have a Family History?

There's a good chance that you'll need your first colon cancer screening before age 45 and/or more frequently than every 10 years. A family history of colon cancer will affect your colonoscopy schedule, and other risk factors can also warrant more frequent screenings. You might be surprised by how common some of the risk factors are. Do any of these risk factors apply to you?

A family history of a hereditary colorectal cancer syndrome, such as familial adenomatous polypsosis (FAP) or Lynch syndrome
A strong family history of colorectal cancer or certain types of polyps
A diagnosis of inflammatory bowel disease (IBS)
A personal history of radiation to the abdomen or pelvic area, for example, to treat a prior cancer
Cancer or certain types of polyps found during a previous screening

Talk to your family members about their medical histories, and make sure your doctor knows about what could factor into your screening schedule.

What If They Find Something?

The reason for the schedule is to catch colon cancer while it's still easy to do something about it. If everything goes according to plan, any cancerous polyps that a colonoscopy discovers will still be in what's called stage zero. Cancerous growths in stage zero have not extended beyond the inner lining of the colon, and can be excised directly by the colonoscope.

Stage one colon cancers have grown deeper into the layers of the colon wall, but have not spread beyond the wall or into the lymph nodes. Many times, if a stage one cancer is a part of a polyp, the polyp can be completely removed during a colonoscopy, making no further colon cancer treatment necessary.

More Advanced Treatment

Unfortunately, it is possible that even if you get your colon cancer screening on schedule, your doctor might find cancer cells that have progressed beyond what can be treated with a colonoscope. If there are cancer cells at the edge of a polyp, or if the cancer has spread along the walls instead of in a polyp, a partial colectomy might be required. In general, this is the last colon cancer treatment you would need.

Other colon cancer treatments including chemotherapy, radiation or other types of surgery might become necessary if the cancer is allowed to progress — which is why it's so important to make sure you are getting your colon cancer screenings on schedule.

You might be dreading your first colorectal cancer screening, whether it's a colonoscopy or a different type of diagnostic test. You might even be a little afraid of what you might learn. But the best — really, the only — way to overcome that fear is to stop cancer before it starts.

Cancer of the colon and rectum is the third most common type of cancer in the United States. The risk for men and women to develop colon cancer or rectal cancer is about 5-6 percent over a lifetime. Several large studies have shown that a history of colon or rectal cancer in a 1st degree relative (parent, brother, sister, or child) increases an individual's chance of developing cancer of the colon or rectum. Family history of pre-cancerous colorectal polyps (mushroom-like growths) also increases one’s risk.
The American Cancer Society, the American Gastroenterological Association, and the National Cancer Institute all recommend men and women begin screening for colorectal cancer at age 50. People with family history should consider screening at a younger age. The first step in prevention starts with a healthy lifestyle. Eating a balanced diet, avoiding excessive alcohol and tobacco use, and exercising are all good ways to reduce cancer risks.
Screening options
An important way to prevent cancer of the colon or rectum is by getting the appropriate screening tests. Removal of pre-cancerous polyps detected through screening can prevent the development of cancer altogether. Several tests and procedures are used to screen for colorectal cancer. For those at average risk, screening is recommended to begin at age 50. Screening options include: yearly fecal occult blood test and flexible sigmoidoscopy every five years, colonoscopy every 10 years, or double contrast Barium enema every five years.
Fecal occult blood test screening consists of examining two or three consecutive stools for microscopic blood findings. Patients with a positive test on any specimen should be followed up with a colonoscopy.

Flexible sigmoidoscopy is a procedure in which the doctor looks inside the rectum and the lower portion of the colon (sigmoid colon) through a flexible, lighted tube called a sigmoidoscope. The doctor may collect samples of tissues or cells for closer examination and remove some polyps within view. Fecal occult blood test and sigmoidoscopy may be used as a combined screening tool, with fecal occult blood test being performed yearly combined with flexible sigmoidoscopy every five years.
A colonoscopy allows inspection and tissue sampling of the rectum and large intestine by inserting a flexible tube with an attached camera throughout the rectum. It allows for greater visualization of the large bowel (upper colon) than the sigmoidoscopy, thereby permitting the detection and removal of polyps and biopsy of cancer throughout the colon. It is considered to be the most accurate screening test for polyps and cancer.
The double-contrast Barium enema consists of a series of x-rays of the colon and rectum. The x-rays are taken after the patient is given an enema, followed by an injection of air. The barium outlines the intestines so that abnormal growths can be seen.
Screening recommendations for those with a family history
- In people with either one first-degree or two second-degree relatives (for instance, an aunt, uncle or grandparent) with colon cancer or pre-cancerous polyps, the above screening is recommended beginning at age 40 instead of 50, with a colonoscopy as the preferred method. A colonoscopy should be repeated at least every five years if the results are negative.
- Colonoscopy screening should begin at 40 years or 10 years earlier than the earliest case of colon cancer in the family. A colonoscopy should be repeated at least every five years if the results are negative.
- When a hereditary colorectal cancer syndrome is suspected or present in a family, members may begin screening at much younger ages and more frequently. In some cases, screening may begin in childhood or early adulthood and will often involve annual colonoscopy (see below for more information).
Genetic counseling
Even stronger family histories of colon cancer may suggest an inherited colon cancer syndrome. People with a family history of colorectal cancer in several close relatives and across generations, especially if these cancers occur at a young age, may benefit from genetic counseling and genetic testing for the inherited syndromes of colon cancer. You can learn more about hereditary colorectal cancer issues through our Colorectal Cancer Risk and Prevention Clinic. To schedule an appointment, call the clinic coordinator at 617-632-2178.

How often should you have a colonoscopy with a family history?

Screening recommendations for those with a family history A colonoscopy should be repeated at least every five years if the results are negative. Colonoscopy screening should begin at 40 years or 10 years earlier than the earliest case of colon cancer in the family.

What is considered a family history of colon cancer?

What is a family history of colon cancer? A family history of colon cancer means that you have an immediate family member (or multiple other family members) who've had colorectal cancer. This can put you at an increased risk for the disease.

Is family history of colon polyps high risk?

A family history of colorectal cancer or adenomatous polyps Still, as many as 1 in 3 people who develop colorectal cancer have other family members who have had it. People with a history of colorectal cancer in a first-degree relative (parent, sibling, or child) are at increased risk.

What are the chances of getting colon cancer if it runs in your family?

If you have familial risk, a single first degree family member (parent or sibling) with colon or endometrial cancer under age 50, your lifetime risk increases to 10-20%. Family history is an important indicator not only because of shared genes, but similar lifestyles too.