Just how risky is it to keep putting off your scheduled colonoscopy? Does a year really make a difference?

People of average risk for colon cancer should begin getting colonoscopies at age 45. Polyps that turn into cancer if left unchecked actually grow quite slowly.

But something that grows very slowly also kills many people.

“If it’s a routine screening colonoscopy done every 10 years, a one-year delay is not a big concern,” begins Joseph Weiss, MD, a certified gastroenterologist and clinical professor of medicine at the Medical School, University of California, San Diego.

“The yield of finding polyps ranges from 25% to 50%,” continues Dr. Weiss. “The yield of actually finding a cancer is less than one percent.

“The real concern of a delay is when it is already at the advanced stage and is about to spread to the lymph nodes or farther (metastases).” The liver is usually the next organ it spreads to.

Nobody can predict when this [metastases] happens with certainty, so there is a theoretical risk that in a one-year delay that the cancer can spread. This is a fraction of one percent possibility.

“Even in higher risk individuals going through more frequent surveillance examinations, the one-year delay is usually not of great concern.

“The time periods advised are all estimates based on large populations.

“What would be of greater value is a time period based on an individual’s risk factors.

“If someone is obese, sedentary, eats hot dogs and pastrami frequently, has a history of inflammatory bowel disease, had colon polyps removed seven years ago, and both his father and brother had colon cancer, I would not recommend delaying one year, one month or one day.

“They are playing Russian Roulette with a relentless and unforgiving foe.”

Nevertheless, even in people who don’t have these multiple blaring risk factors — such as a normal-weight man over 60 with no family history who had a few small precancerous polyps removed and was instructed to have a repeat colonoscopy in three years – the colonoscopy after three years isn’t going to be more inconvenient than if he waited another year.

So he may as well have it after three years instead of putting it off.

If you put it off a year, what’s then to stop you from putting it off yet another year?

Before you know it, six years will have passed when that surveillance interval should’ve been three years.

Dr. Weiss is the author of Got Guts! A Guide to Prevent and Beat Colon Cancer. He has also presented numerous presentations on various health topics.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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