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There are a few risk factors to be aware of that imply you may need a colonoscopy at an earlier age than is recommended for the general population.
Family History – Patients who have a first-degree relative with colon cancer or advanced adenoma/polyp diagnosed at any age should be advised to have a screening colonoscopy starting at age 40, or 10 years younger than the earliest diagnosis in their family, whichever comes first. A colonoscopy should be repeated every five years for those with more than 1st degree relatives with colon cancer at any age or a single 1st degree relative diagnosed <60 years of age.
Personal History – History of colon polyps found on a prior colonoscopy. History of inflammatory bowel disease such as Crohn’s disease or Ulcerative colitis.
A few other risk factors that do not necessarily alter the timing of initiation of colonoscopy include:
- Diabetes mellitus
- Obesity – Defined as a body mass index greater than 30 and is associated with a 1.5-2 fold increased risk of colon cancer compared to the general population as well as increased risk of death from colon cancer.
- Smoking – As with many other malignancies, cigarette smoking increases the risk for colon cancer. Smoking is the #1 preventable risk factor that imparts the greatest deleterious effect on one’s overall health and should be completely avoided
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