Frederick Gandolfo, MD

Dear Retroflexions, As a victim of anal rape by my domestic married partner, I never recovered...

If you notice, the basic idea here is pretty simple. According to the guidelines, there are really only a few options for follow-up intervals for colonoscopy: 10 years (negative exam), 5 years (low risk polyps), and 3 years (high risk polyps). Less than 3 years is only recommended in the truly unusual case of a large polyp burden or invasive cancer in a polyp. And that's it.

I thought it would be a good time to show a real-life example of colorectal cancer prevention in action. Let's pretend that you are a friendly neighborhood gastroenterologist, just minding your own business and doing a screening colonoscopy on a patient.

It is sometimes an awkward conversation to have, but the truth is that at a certain age, we eventually stop checking people for things that may cause them future harm.

Clearly, the screening guidelines recommend repeating a negative colonoscopy in ten years. Now what if I told you that many (if not most) practicing gastroenterologists recommend repeating the test in five years, not ten?

If there is one take-home message for colorectal cancer screening it is this: Start screening most people at age 50. Colonoscopy is the preferred screening test.