How Often Should You Get a Colonoscopy? Risks and Recommendations

Colonoscopy duration

Hello, doctor.
How often should I have a colonoscopy? I have internal hemorrhoids, and if I strain too much during bowel movements, I might experience bleeding.
However, using suppositories helps improve the bleeding symptoms.
I had a gastrointestinal endoscopy last year and the year before, and I had one polyp removed from my colon each year, which was confirmed to be non-cancerous.
Do I need to have a colonoscopy every year? No one in my family has a history of colon cancer.
Does having polyps put me in a high-risk group? If I have a colonoscopy every 2 to 3 years, is that considered safe? Also, does colorectal cancer develop from polyps? How long does it typically take for changes to occur? Thank you for your help, doctor.

MM, 40~49 year old female. Ask Date: 2017/05/15

Dr. Chen Jiaming reply Surgery

The current consensus in the medical community is that if polyps are found during a colonoscopy, in addition to removing the polyps at that time, it is recommended to undergo another colonoscopy one year later.
If no new polyps are detected during that follow-up examination, then a colonoscopy can be performed every two years thereafter.
Polyps are generally considered precursors to colorectal cancer, although the time frame for their progression can vary.
Familial polyposis is characterized by the development of multiple polyps and is not simply defined by having a family member with sporadic polyps.

Reply Date: 2017/05/15

More Info

When it comes to colonoscopies, the frequency at which you should undergo this procedure largely depends on your individual risk factors, including your medical history, family history, and the findings from previous colonoscopies. Given your situation, where you have a history of polyps and internal hemorrhoids, it is essential to understand the recommendations and risks associated with colonoscopies.

General Recommendations for Colonoscopy Frequency
1. Average Risk Individuals: For individuals at average risk of colorectal cancer, the general recommendation is to start screening at age 45 and to repeat the colonoscopy every 10 years if no polyps are found.

2. Increased Risk Individuals: If you have a history of adenomatous polyps (like the ones you've had removed), the recommendations change. Typically, if you have had one or two small polyps (less than 1 cm) that are not cancerous, a follow-up colonoscopy is usually recommended every 5 to 10 years. However, if you have had multiple polyps or polyps with dysplastic changes, your doctor may recommend a colonoscopy every 3 years.

3. Family History: Since you mentioned that there is no family history of colorectal cancer, this may lower your risk slightly. However, your personal history of polyps still places you at an increased risk, which is why regular monitoring is crucial.

Understanding Polyps and Cancer Risk
Polyps are growths on the lining of the colon that can vary in size and type. The majority of polyps are benign, but certain types, particularly adenomatous polyps, have the potential to develop into colorectal cancer over time. The process of a polyp becoming cancerous can take several years, often estimated to be around 5 to 10 years, depending on various factors including the type of polyp and individual genetic predispositions.

Risks of Colonoscopy
While colonoscopy is generally considered a safe procedure, it does carry some risks, including:
- Perforation: This is a rare but serious complication where a hole is made in the wall of the colon, which can lead to infection and may require surgical intervention.

- Bleeding: This can occur, especially if a polyp is removed, but is usually manageable.

- Sedation Risks: As with any procedure involving sedation, there are risks associated with anesthesia.

Recommendations Based on Your Situation
Given that you have had polyps removed in the past, it is advisable to continue with regular screenings. While you may be tempted to extend the interval to 2 or 3 years, it is essential to consult with your gastroenterologist. They may recommend sticking to an annual or biannual schedule, especially since you have had polyps removed in consecutive years.

Conclusion
In summary, while the average person may only need a colonoscopy every 10 years, your history of polyps necessitates a more vigilant approach. Regular screenings are vital in preventing the progression of polyps to colorectal cancer. It is crucial to maintain open communication with your healthcare provider to determine the best screening schedule tailored to your health needs. Always prioritize your health and follow the recommendations of your healthcare team to ensure early detection and prevention of potential complications.

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