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When Should You Get a Colonoscopy? A Guide for Adults in Denton, TX
- Comprehensive Gastroenterology P.A.
- October 21, 2026
- 7 min read
Quick Answer
Most adults at average risk should have their first colon cancer screening at age 45. If a colonoscopy is normal, it is usually repeated every 10 years. You may need to start earlier or be screened more often if you have a family history of colon cancer or advanced polyps, inflammatory bowel disease, or symptoms such as rectal bleeding.
Colon Cancer Screening at a Glance
Key numbers for average-risk adults
Why Colon Cancer Screening Matters
Colorectal cancer is one of the most common cancers in the United States, yet it is also one of the most preventable. Most colon cancers start as small growths called polyps that change slowly over several years. A colonoscopy allows your gastroenterologist to find and remove those polyps before they ever become cancer.
- Prevention: removing polyps stops cancer before it starts.
- Early detection: cancers found early are far easier to treat.
- Peace of mind: a normal result usually means no repeat exam for 10 years.
How Colon Cancer Usually Develops
Most colorectal cancers grow slowly from polyps, which is why screening works
Normal cells line the colon and rectum.
A growth develops on the lining. Most cause no symptoms.
Some polyps (adenomas) slowly develop abnormal changes.
Without removal, some polyps can turn into cancer. Colonoscopy can remove polyps before this happens.
The Recommended Screening Age Is Now 45
National guidelines lowered the starting age for average-risk adults from 50 to 45 because colorectal cancer is being diagnosed more often in younger adults. Screening is generally recommended through age 75. Between ages 76 and 85, the decision is made individually with your doctor based on your health and screening history.
Who Should Be Screened Earlier or More Often?
You may be at higher than average risk if any of the following apply to you:
- Family history: a parent, sibling or child with colorectal cancer or advanced polyps.
- Personal history: previous polyps or colorectal cancer.
- Inflammatory bowel disease: long-standing Crohn’s disease or ulcerative colitis.
- Hereditary syndromes: such as Lynch syndrome or familial adenomatous polyposis (FAP).
- Prior radiation: to the abdomen or pelvis for an earlier cancer.
If any of these sound familiar, talk with a gastroenterologist about when to start and how often to repeat screening.
Screening Start Age by Risk Level
General guideline ranges; your doctor will personalize your plan
| Risk Level | When to Start | How Often (if normal) |
|---|---|---|
| Average risk | Age 45 | Every 10 years |
| Parent, sibling or child with colon cancer or advanced polyp diagnosed before 60 (or two or more such relatives) | Age 40, or 10 years before the youngest relative’s diagnosis | Every 5 years |
| Ulcerative colitis or Crohn’s colitis | About 8 years after symptoms begin | Every 1 to 3 years |
| Lynch syndrome | Age 20 to 25 | Every 1 to 2 years |
Guideline ranges summarized for education. Your gastroenterologist will set your exact schedule.
Colonoscopy vs. Other Screening Tests
Several screening options exist for average-risk adults. The best test is the one you will actually complete, but they are not all the same.
| Test | How It Works | How Often* | If Abnormal |
|---|---|---|---|
| Colonoscopy | Camera exam of the entire colon; polyps removed during the test | Every 10 years | Treatment often done in the same visit |
| FIT (stool test) | Checks stool for hidden blood | Every year | Follow-up colonoscopy needed |
| Stool DNA test | Checks stool for blood and DNA changes | Every 1 to 3 years | Follow-up colonoscopy needed |
| CT colonography | CT scan images of the colon | Every 5 years | Follow-up colonoscopy needed |
*Intervals are for average-risk adults with normal results. This table is a guide, not a diagnosis. Your doctor will recommend the right test and schedule for you.
Symptoms That Should Not Wait for a Screening Date
Screening is for people without symptoms. If you notice any of the following, make an appointment with a gastroenterologist rather than waiting for a routine screening:
- Rectal bleeding or blood in the stool
- A change in bowel habits lasting more than a few weeks
- Unexplained iron-deficiency anemia or fatigue
- Persistent abdominal pain or cramping
- Unintentional weight loss
Warning Signs: Don’t Wait for Screening
See a gastroenterologist promptly if you notice any of these
What to Expect: Before, During and After
Your Colonoscopy Timeline
What happens and when
Review blood thinners, diabetes medicines and weight-loss injections with our team. Pick up your bowel prep.
Avoid nuts, seeds and high-fiber foods if instructed.
Clear liquid diet only. Start your bowel prep as directed.
Finish the prep, arrive with your driver, and receive sedation. The exam takes about 30 to 60 minutes.
Biopsy or polyp results are ready and your next screening date is set.
Before your colonoscopy
- Review your medications. Tell our team about blood thinners, diabetes medicines and weight-loss injections.
- Follow a clear liquid diet the day before your procedure.
- Complete your bowel prep exactly as instructed. A clean colon lets even small polyps be seen.
- Arrange a driver. You cannot drive after sedation.
During the procedure
- You receive sedation and rest comfortably on your side.
- Dr. Awan examines the colon and removes any polyps.
- The exam itself usually takes about 30 to 60 minutes.
After the procedure
- You rest briefly while the sedation wears off.
- Mild gas or bloating is common and passes quickly.
- Dr. Awan explains the findings, and biopsy results are typically ready within a few days.
How Often Do You Need a Repeat Colonoscopy?
- Normal exam, average risk: usually every 10 years.
- One or two small, low-risk polyps: often 7 to 10 years.
- Several polyps, larger polyps or advanced features: often 3 to 5 years, sometimes sooner.
- Family history or IBD: a personalized schedule set by your gastroenterologist.
Your exact interval depends on the number, size and type of polyps found, so always follow your doctor’s recommendation.
Repeat Colonoscopy Intervals After Polyps
Based on current U.S. multi-society guidance for adults at average risk
| Finding at Colonoscopy | Typical Next Colonoscopy |
|---|---|
| Normal exam | 10 years |
| 1 to 2 small adenomas (under 10 mm) | 7 to 10 years |
| 3 to 4 small adenomas (under 10 mm) | 3 to 5 years |
| 5 to 10 small adenomas | 3 years |
| Adenoma 10 mm or larger, or with advanced features | 3 years |
| Small hyperplastic polyps in the rectum or sigmoid colon | 10 years |
Intervals depend on pathology, prep quality and personal history. Always follow your doctor’s recommendation.
When to See a Gastroenterologist in Denton
If you are 45 or older and have never been screened, are due for a repeat exam, or have any of the symptoms above, it is time to schedule a visit. Dr. Amjad Awan has performed colonoscopies for patients in Denton, Lewisville and Coppell for 25 years. Call (940) 243-0912 or request an appointment online. Learn more about colonoscopy in Denton, TX.
Frequently Asked Questions
Does a colonoscopy hurt?
Colonoscopy is performed with sedation, so most patients are comfortable and remember little of the procedure. Mild bloating afterward is common and short-lived.
Is 45 too early for a colonoscopy?
No. Guidelines recommend that adults at average risk begin screening at 45 because colon cancer is increasingly found in younger adults.
Can I use a stool test instead of a colonoscopy?
Stool tests are an option for some average-risk adults, but they must be repeated more often and a positive result requires a colonoscopy.
How long does the whole visit take?
Plan for about two to three hours including check-in, the procedure and recovery. The procedure itself usually takes 30 to 60 minutes.
Can I go back to work the same day?
Because of sedation, you should not drive or work for the rest of the day. Most people return to normal activities the next day.
Disclaimer: This article is for general education and does not replace professional diagnosis or treatment. If you have symptoms or questions about your digestive health, please talk with a qualified healthcare provider.
Contact Our Office
Dr. Awan has cared for patients in Denton County for 25 years with Comprehensive Gastroenterology P.A. He provides colonoscopy, upper endoscopy, ERCP, endoscopic ultrasound and treatment for the complete range of digestive, liver and pancreatic conditions, with a focus on clear explanations and personal care.
Table of Contents
- Why Colon Cancer Screening Matters
- The Recommended Screening Age Is Now 45
- Who Should Be Screened Earlier or More Often?
- Colonoscopy vs. Other Screening Tests
- Symptoms That Should Not Wait for a Screening Date
- What to Expect: Before, During and After
- How Often Do You Need a Repeat Colonoscopy?
- When to See a Gastroenterologist in Denton
- FAQs
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