According to data from the Ministry of Health, colorectal cancers rank third among all types of cancer in terms of incidence in Turkey. While several environmental and genetic risk factors contribute to the development of this cancer type, age remains one of the most significant risk factors. Although the disease is rarely seen under the age of 40, its frequency increases significantly after the ages of 40–50.
Colorectal cancers tend to grow slowly, and the most important factor influencing their course is the stage at which the disease is diagnosed. Even in individuals without any symptoms, early-stage diagnosis is possible — and early-stage colorectal cancer is largely treatable. Moreover, the removal of polyps, which are precancerous growths in the colon, can effectively prevent the disease. However, early detection is currently achieved in only about 40% of cases. For this reason, screening tests such as colonoscopy should not be neglected and must be performed on time.
This brings us to a common and important question: At what age should colonoscopy screening begin?
In Turkey, the recommended starting age for colonoscopy was 50 years until 2018. However, in recent years, there has been a noted increase in the presence of polyps and colorectal cancer in younger individuals. In response, the American Cancer Society (ACS) issued new guidelines in 2018, recommending that screening begin at age 45 instead of 50 for individuals at average risk.
Based on these updated guidelines, people with no known risk factors should begin colonoscopy screening at age 45. However, individuals with certain risk factors — such as a personal history of inflammatory bowel disease, or a family history of colon or rectal cancer — may need to begin screening at an even earlier age, depending on their clinical background.
