Colonoscopy Screening: What It Is, Who Needs It, and What to Expect

When it comes to catching colon cancer before it becomes life-threatening, colonoscopy screening, a direct visual exam of the colon using a flexible camera to detect polyps and early tumors. Also known as bowel cancer screening, it’s the gold standard for preventing colorectal cancer by removing precancerous growths before they spread. Unlike stool tests or CT scans, a colonoscopy lets your doctor see exactly what’s happening inside your colon—and act right away.

Most people should start colonoscopy screening at 45, especially if they have no family history or symptoms. But if you have a parent or sibling who had colon cancer, you might need to start earlier. People with inflammatory bowel disease, like ulcerative colitis, also need regular screenings. The procedure itself takes about 30 minutes, and you’re sedated so you won’t feel a thing. The real work comes before it: the prep. You’ll need to drink a laxative solution, stick to clear liquids, and avoid solid food for a full day. It’s not fun, but skipping it means missing the chance to catch a tumor when it’s still easy to remove.

Colonoscopy screening isn’t just about finding cancer. It’s about stopping it. Over 90% of colon cancers start as harmless polyps, and removing them during the procedure cuts your risk by up to 70%. Some people worry about the risks—perforation, bleeding, or reactions to sedation—but serious complications happen in less than 1 in 1,000 cases. The real danger? Not doing it. Colon cancer often shows no symptoms until it’s advanced, which is why waiting for pain or blood in stool is a dangerous gamble.

After your colonoscopy, you’ll get results right away. If everything looks normal, you won’t need another for 10 years. If polyps are found, your next one could be in 3 to 5 years, depending on size and type. Your doctor will tell you what’s normal for your case. And if you’re nervous? You’re not alone. Millions of people feel the same way. But the truth is, most people who get screened walk out feeling relieved—not because they found cancer, but because they didn’t.

Below, you’ll find real-world guides on what to expect before, during, and after your colonoscopy, how to handle the prep without losing your mind, and what to do if you’re told you have polyps. These aren’t theoretical tips—they’re from people who’ve been through it, and they know what actually works.