At what age should you get a colonoscopy?
For average-risk adults, colorectal cancer screening starts at 45 under the current U.S. task force recommendation; a colonoscopy every 10 years is one of several options, not the only one.
Arun Verma, co-founder of Triangle · 2026-10-19
This is not clinical evidence and not medical advice. It does not replace your care team. Discuss anything here with your clinician before you act on it.
At what age should you get a colonoscopy?
For average-risk adults, colorectal cancer screening generally begins at age 45, and a screening colonoscopy every 10 years is one recommended option. The U.S. Preventive Services Task Force (USPSTF) recommendation of May 18, 2021, calls for screening adults aged 45 to 75, with colonoscopy every 10 years listed among the strategies, and it treats ages 76 to 85 as an individual decision. Colonoscopy is not the only test. The same recommendation lists stool-based tests and other visual exams with different intervals. Which test fits you, and when to start if your history differs from average risk, is a question for your clinician, not a page.
What ages does the USPSTF recommend for colorectal cancer screening?
Three age bands, dated May 18, 2021. The USPSTF gives Grade A to screening all adults aged 50 to 75, Grade B to screening adults aged 45 to 49, and Grade C to selectively offering screening to adults aged 76 to 85 based on overall health, prior screening history, and preferences. It recommends offering screening starting at age 45 and says screening should be discontinued after age 85. The recommendation applies to asymptomatic adults at average risk. CDC restates the Task Force line as screening ages 45 to 75, with ages 76 to 85 decided individually. An August 2026 analysis of SEER data in the American Journal of Preventive Medicine looked at colorectal cancer incidence in adults 20 to 54 and found that after the USPSTF lowered the average-risk screening start age to 45 in 2021, the steepest recent rise was among adults 45 to 49, especially in early-stage diagnoses.
How often is a screening colonoscopy recommended?
Every 10 years for people at average risk with a negative screening colonoscopy, under the USPSTF strategy list. CDC gives the same interval for people who do not have an increased risk. NCI says experts recommend screening colonoscopy every 10 years for people at average risk. That interval is for screening when findings are negative, not for surveillance after polyps or prior findings. The U.S. Multi-Society Task Force (MSTF) still ranks high-quality colonoscopy every 10 years as a first-tier option alongside annual FIT.
How do other colorectal screening tests compare, and what intervals do sources give?
Several tests share the same age window; they differ in how often they repeat and what happens after an abnormal result. USPSTF strategies include high-sensitivity guaiac fecal occult blood test (HSgFOBT) or fecal immunochemical test (FIT) every year, stool DNA-FIT every 1 to 3 years, CT colonography every 5 years, flexible sigmoidoscopy every 5 years, flexible sigmoidoscopy every 10 years plus annual FIT, and colonoscopy every 10 years. CDC describes the same family of stool and visual tests. NCI notes that people who have a positive stool test are advised to have a colonoscopy. A fair question for your team is which test you last had, on what date, and which interval they are using.
Why might someone start screening earlier than 45?
Some people are advised to begin before the average-risk start of 45, or to screen on a shorter interval. CDC lists a personal or family history of colorectal cancer or colorectal polyps, and genetic syndromes such as familial adenomatous polyposis (FAP) or Lynch syndrome, among reasons screening may start earlier or happen more often. NCI says people at increased risk because of certain inherited conditions, a family history of colorectal cancer, or a personal history of advanced polyps may be advised to start earlier or screen more often. The page does not decide your start age; a fair question for your clinician is whether your history moves you off the average-risk schedule.
Why does a positive stool test lead to a follow-up colonoscopy?
Because the screening benefit of a stool test is completed only when an abnormal result is followed by colonoscopy. USPSTF says that when stool-based tests reveal abnormal results, follow-up with colonoscopy is needed for further evaluation, and that abnormal results from stool-based tests, CT colonography, and flexible sigmoidoscopy should be followed up with colonoscopy. CDC says that if your result is positive or abnormal on stool tests, flexible sigmoidoscopy, or CT colonography, a colonoscopy is needed to complete the screening process. NCI says people with a positive finding on stool tests are advised to have a colonoscopy.
How can you find the date of your last colonoscopy in your records?
Colonoscopy dates and findings generally sit in the medical and billing records held by the covered providers and health plans that ordered or performed the test. Under HIPAA, you generally have the right to inspect, review, and receive a copy of your medical and billing records held by covered providers and health plans. A fair question for each office that may have done the test is when your last colonoscopy was and what the report found. If reports are split across moves or new doctors, a fair question for each office is whether you can get copies so the dates line up in one place.
What could you ask your clinician about colonoscopy age and history?
You could ask whether you are on the average-risk schedule that starts at 45, whether your history calls for an earlier start or a shorter interval, which screening test they recommend next, and when your last colorectal screening was and what it found. CDC's list for people who may have higher risk includes when to begin, which test is right for you, and how often to get tested. No source says what any one person should do on a given birthday; that call belongs with the people who know your screening history and overall health.
Sources
- USPSTF: Colorectal Cancer: Screening (final recommendation, May 18, 2021): USPSTF recommends screening for colorectal cancer in all adults aged 50 to 75 years (Grade A), in adults aged 45 to 49 years (Grade B), and that clinicians selectively offer screening in adults aged 76 to 85 years considering overall health, prior screening history, and preferences (Grade C); recommendation dated May 18, 2021.
- USPSTF: Colorectal Cancer: Screening (final recommendation, May 18, 2021): USPSTF recommends offering colorectal cancer screening starting at age 45 years.
- USPSTF: Colorectal Cancer: Screening (final recommendation, May 18, 2021): USPSTF says screening should be discontinued after age 85 years.
- USPSTF: Colorectal Cancer: Screening (final recommendation, May 18, 2021): USPSTF recommended screening strategies include HSgFOBT or FIT every year, stool DNA-FIT every 1 to 3 years, CT colonography every 5 years, flexible sigmoidoscopy every 5 years, flexible sigmoidoscopy every 10 years plus annual FIT, and colonoscopy screening every 10 years.
- USPSTF: Colorectal Cancer: Screening (final recommendation, May 18, 2021): USPSTF says this recommendation applies to asymptomatic adults 45 years or older at average risk of colorectal cancer.
- USPSTF: Colorectal Cancer: Screening (final recommendation, May 18, 2021): USPSTF says when stool-based tests reveal abnormal results, follow-up with colonoscopy is needed for further evaluation.
- USPSTF: Colorectal Cancer: Screening (final recommendation, May 18, 2021): USPSTF says that to achieve the benefits of screening, abnormal results from stool-based tests, CT colonography, and flexible sigmoidoscopy should be followed up with colonoscopy.
- CDC: Screening for Colorectal Cancer (page reviewed June 17, 2026): CDC says the U.S. Preventive Services Task Force recommends that adults age 45 to 75 be screened for colorectal cancer, and that the decision to be screened between ages 76 and 85 should be made on an individual basis.
- CDC: Screening for Colorectal Cancer (page reviewed June 17, 2026): CDC says most people should begin screening for colorectal cancer at age 45.
- CDC: Screening for Colorectal Cancer (page reviewed June 17, 2026): CDC says you may need to start screening earlier than 45, or get screened more often than other people, if you have a personal or family history of colorectal cancer or colorectal polyps, or a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).
- CDC: Screening for Colorectal Cancer (page reviewed June 17, 2026): CDC says if you think you may have an increased risk for colorectal cancer, talk to your doctor about when to begin screening, which test is right for you, and how often to get tested.
- CDC: Screening for Colorectal Cancer (page reviewed June 17, 2026): CDC says colonoscopy how often is every 10 years for people who do not have an increased risk of colorectal cancer.
- CDC: Screening for Colorectal Cancer (page reviewed June 17, 2026): CDC says colonoscopy also is used as a follow-up test if anything unusual is found during one of the other screening tests, and that if your test result is positive or abnormal on stool tests, flexible sigmoidoscopy, and CT colonography, a colonoscopy test is needed to complete the screening process.
- NCI: Screening Tests to Detect Colorectal Cancer and Polyps (reviewed October 29, 2024): NCI says most expert medical groups now generally recommend that people at average risk of colorectal cancer get screened at regular intervals beginning at age 45, that screening generally continue to age 75, and that for ages 76 to 85 the decision to screen is based on the individual's life expectancy, health conditions, and prior screening results.
- NCI: Screening Tests to Detect Colorectal Cancer and Polyps (reviewed October 29, 2024): NCI says experts recommend screening colonoscopy every 10 years for people at average risk.
- NCI: Screening Tests to Detect Colorectal Cancer and Polyps (reviewed October 29, 2024): NCI says people who have a positive finding with stool tests are advised to have a colonoscopy.
- NCI: Screening Tests to Detect Colorectal Cancer and Polyps (reviewed October 29, 2024): NCI says people who are at increased risk of colorectal cancer because of certain inherited conditions (such as Lynch syndrome and familial adenomatous polyposis), a family history of colorectal cancer, or a personal history of advanced polyps may be advised to start screening earlier and/or have more frequent screening.
- U.S. Multi-Society Task Force: Updates on Age to Start and Stop Colorectal Cancer Screening (Gastroenterology, published online November 15, 2021): U.S. Multi-Society Task Force on Colorectal Cancer suggests that clinicians offer CRC screening to all average-risk individuals ages 45 to 49 (weak recommendation; low-quality evidence), and for average-risk individuals who have not initiated screening before age 50 recommends offering screening beginning at age 50 (strong recommendation, high-quality evidence).
- U.S. Multi-Society Task Force: Colorectal Cancer Screening: Recommendations for Physicians and Patients (Am J Gastroenterol / Gastroenterology, 2017): MSTF recommends high-quality colonoscopy every 10 years or an annual FIT as first-tier options for screening of colorectal neoplasia (strong recommendation; moderate-quality evidence).
- U.S. Multi-Society Task Force: Updates on Age to Start and Stop Colorectal Cancer Screening (Gastroenterology, published online November 15, 2021): MSTF says for individuals ages 76 to 85, the decision to start or continue screening should be individualized and based on prior screening history, life expectancy, CRC risk, and personal preference, and that screening is not recommended after age 85.
- HHS: Your Medical Records (content last reviewed May 30, 2025): HHS says the Privacy Rule gives you, with few exceptions, the right to inspect, review, and receive a copy of your medical records and billing records that are held by health plans and health care providers covered by the Privacy Rule.
- American Journal of Preventive Medicine: Age and Stage Trends in Early-Onset Colorectal Cancer Incidence Before and After the USPSTF 2021 Update (epub 2026 Aug 25); PubMed 42641713: An August 2026 American Journal of Preventive Medicine analysis of SEER data (2004-2023) reported that after the 2021 USPSTF change of the average-risk screening start age from 50 to 45, the largest recent increase in recorded early-onset colorectal cancer incidence was among adults aged 45 to 49 (all-stage APC from 1.31%/yr in 2004-2019 to 14.38%/yr in 2021-2023), with early-stage CRC in that age group rising from 0.12%/yr to 32.14%/yr; the authors suggested increased detection after expanded screening eligibility.
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