Colorectal cancer is the second leading cause of cancer death in the United States. It is also one of the most preventable — because unlike most cancers, it develops predictably from precancerous polyps that can be identified and removed during the very screening procedure most people are putting off.
That procedure is the colonoscopy. And the most important thing most people don’t know about it is that the version of it living in their imagination — daunting, uncomfortable, something to deal with eventually — bears almost no resemblance to what a modern colonoscopy actually involves.
At The Gastroenterology Practice, with offices in Queens and Levittown, Dr. Mit Shah and Dr. Davinder Singh provide colonoscopy and comprehensive GI care to patients throughout Long Island and the greater New York metro area. Dr. Shah brings over a decade of experience and has been recognized with the “Fellow of the Year” distinction. Dr. Singh’s training at the Mayo Clinic and Cleveland Clinic — where he performed advanced endoscopic procedures and trained future gastroenterologists — brings a level of subspecialty depth to the practice that patients in Queens and Long Island deserve access to locally.
The Guidelines Changed — and Most People Don’t Know
In 2021, the American Cancer Society updated its colorectal cancer screening guidelines, lowering the recommended starting age for average-risk individuals from 50 to 45. The US Preventive Services Task Force followed with the same recommendation. This change reflects the alarming increase in colorectal cancer diagnoses in adults under 50 — a trend that has made early screening a clinical priority rather than an optional precaution.
Most people who are 45 or older and haven’t had a colonoscopy believe they’re within the timeframe of the old guidelines. They’re not. The new standard begins at 45 — and the five years between 45 and 50 are years during which precancerous polyps can develop, grow, and be addressed if found, or go undetected if not screened.
What Colonoscopy Actually Finds
A colonoscopy allows direct visual examination of the entire inner surface of the colon and rectum using a thin, flexible camera. The procedure identifies:
- Polyps: Precancerous growths that are removed during the same procedure. Most colorectal cancers develop from adenomatous polyps over a period of years. A polyp removed during colonoscopy is a cancer that didn’t happen.
- Early-stage cancer: Identified at a stage when treatment is most effective and survival rates are highest.
- Inflammatory conditions: Including inflammatory bowel disease, which may require specific management.
- Other structural abnormalities that affect GI function and may explain symptoms the patient has been living with.
For patients with no polyps or abnormal findings, the next colonoscopy is typically not needed for ten years — a decade of protection from a single procedure.
The Prep — What It Actually Involves Now
The colonoscopy preparation — drinking the bowel-cleansing solution the day before the procedure — is the most frequently cited reason patients defer. The solutions used today are significantly more tolerable than those of previous decades. Lower-volume preparations, split-dose protocols, and flavoring options have made the preparation process substantially more manageable.
Patients who haven’t had a colonoscopy in years, and whose mental image of the prep is based on what a family member described fifteen years ago, are comparing their expectation to an experience that no longer represents current clinical practice.
The Procedure Itself
Colonoscopy is performed under sedation — patients are comfortable and typically have little or no memory of the procedure. The procedure takes approximately 20 to 30 minutes for a screening colonoscopy. Patients need a companion to drive them home after sedation, but most return to normal activity the following day.
The fear of the procedure that keeps patients from scheduling it is almost always larger than the procedure itself. Patients who undergo colonoscopy consistently report that the experience was far less difficult than they anticipated.
Schedule Your Colonoscopy at The Gastroenterology Practice
Dr. Mit Shah, Dr. Davinder Singh, and the team serve patients throughout Queens, Long Island, and the greater New York area from offices in Queens (222-15 Northern Boulevard, 4th Floor) and Levittown. Contact the practice through thegipractice.com to schedule your colonoscopy or initial GI consultation. If you’re 45 or older and haven’t had a colonoscopy, the most useful action you can take for your long-term health is scheduling this appointment. The polyp that gets found and removed this year is the one that doesn’t become a problem five years from now.
This blog is educational. Colorectal cancer screening recommendations vary based on individual risk factors. Please consult with a board-certified gastroenterologist to determine the appropriate screening schedule for your situation.
Who Should Be Screened Earlier Than 45
Average-risk colonoscopy begins at 45. Certain risk factors move the starting age earlier — and knowing whether you fall into these categories is part of what the GI consultation establishes:
- Family history of colorectal cancer or advanced polyps: A first-degree relative (parent, sibling, or child) diagnosed with colorectal cancer or advanced adenomatous polyps before age 60 typically moves the recommended starting age to 40, or 10 years before the relative’s diagnosis — whichever comes first. A family history is one of the most significant modifiable risk reduction opportunities: knowing it exists allows for earlier screening that can catch the same pattern before it produces the same outcome.
- Personal history of inflammatory bowel disease: Patients with Crohn’s disease or ulcerative colitis affecting the colon have elevated colorectal cancer risk and require surveillance colonoscopy at intervals determined by disease duration and extent — typically beginning eight years after diagnosis.
- Certain genetic syndromes: Lynch syndrome and familial adenomatous polyposis (FAP) carry significantly elevated colorectal cancer risk and require colonoscopy beginning in adolescence or early adulthood, with frequent surveillance intervals.
- Symptoms that warrant evaluation regardless of age: Rectal bleeding, changes in bowel habits lasting more than a few weeks, unexplained weight loss, persistent abdominal pain, or unexplained iron-deficiency anemia all warrant evaluation with a gastroenterologist — and colonoscopy may be indicated at any age when these symptoms are present.
Dr. Shah and Dr. Singh assess each patient’s specific risk profile at the initial consultation and recommend the screening approach that matches the individual clinical picture.
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