Not everyone needs a colonoscopy right away. Depending on your risk level, you might start with a stool-based test like FIT or Cologuard . But if those tests come back abnormal, a follow-up colonoscopy is essential.

The key is having a conversation with your doctor about what’s right for you—not just following general guidelines.

What to Discuss with Your Doctor

Based on your age, family history, and personal health, you and your doctor should determine:

Factor Questions to Ask
When to start Should I begin screening before age 45?
How often Every 10 years? 5 years? More often?
Which test Colonoscopy, FIT, Cologuard, or another option?
Your risk factors Do I have a family history? Personal history of polyps? Inflammatory bowel disease?

Who Needs to Start Earlier?

You may need to begin screening before age 45 or have more frequent colonoscopies if you have :

  • A first-degree relative (parent, sibling, or child) with colorectal cancer or polyps