Colonoscopy

Our specialists provide the latest advances for colonoscopies, using a range of sophisticated tools and technologies to make your experience comfortable and easy. Stanford offers screening colonoscopies to help prevent cancer or detect it early, as well as diagnostic colonoscopies to evaluate you if you are having bowel symptoms. We also serve as a referral center for people who have had difficult or incomplete colonoscopies at other centers.

Even if you have complicated polyps or complex anatomy, our team has special expertise in removing large and difficult-to-treat polyps. Our team uses special scopes and its experience to make colonoscopy possible for most people.

What is a colonoscopy?

Colonoscopy is an important diagnostic and therapeutic procedure that helps manage your digestive health. A colonoscopy examines your large intestine (colon and rectum) for signs of colon polyps, colorectal cancer, and other conditions. A long, flexible tube with a camera attached to it (colonoscope) is inserted through your rectum into your colon.

During colonoscopy, the colonoscope enables your doctor to access your bowel to irrigate, suction, or inject air into the region, and to pass specialized instruments through it, as needed. Tissue and polyps may be removed for further examination and treatment.

When should you have a colonoscopy?

A colonoscopy may be recommended by your doctor if you are having bowel or other symptoms, including bleeding, diarrhea, or pain. If you are not having symptoms, the standard age for a first screening colonoscopy for most people is 50 years old.

The risk of colorectal cancer increases with age. However, polyps that can later develop into cancer are visible as early as 10 years before they become cancerous. By having these polyps removed starting at age 50, you may prevent colorectal cancer. Learn more about colorectal cancer and the genetic risk for colorectal cancer.

If you have a family history of colorectal cancer, or an identified genetic risk for colon cancer, your doctor will likely recommend a first colonoscopy at age 40 or earlier. Some experts recommend that African American men and women should be screened earlier, starting at age 45.

Guidelines for colorectal screening include:

• A personal history of colorectal cancer: Follow your personal screening plan identified by your doctors
• A personal history of chronic inflammatory bowel disease: Begin screening 8-10 years after having significant colon inflammation
• A parent, sibling, or child in your family under 60 years of age who has had colorectal cancer or colon polyps: Begin screening at age 40 or 10 years before the youngest age of colorectal cancer diagnosis in your family
• A personal family history of hereditary colorectal cancer syndromes, such as familial adenomatous polyposis and Lynch syndrome or hereditary non-polyposis colon cancer (HNPCC): Begin screening in the teen years or early 20s, based on expert advice from your doctors.

In 2008, the American Cancer Society approved virtual colonoscopy as an alternative to traditional colonoscopy. Learn more about virtual colonoscopy.

What happens after your first colonoscopy?

If that first colonoscopy is clear and you have no polyps, another colonoscopy will probably be recommended in 10 years.

Can younger people also have colon cancer and require screening?

New data suggests a rise in the incidence of colorectal cancer in younger people. The rate is still low, but it raises the possibility that environmental factors may be changing the risk of colon cancer in this younger population. As of now, routine screening is not recommended before age 50, but if you have symptoms, such as bleeding, severe change in bowel movements, pain or weight loss, you should see your doctor promptly to discuss whether you should have a colonoscopy.

If you have a strong family history of polyps or colon cancer, you may need to be screened at younger ages, in some cases in your 20s or younger. It is important to know your family’s medical history and to discuss it with your doctor, and then determine whether you need to meet with a Cancer Genetics team, including a genetic counselor.

Learn more about our Gastrointestinal (GI) Cancer Program and Cancer Genetics Program.