Colon cancer screening: when is colonoscopy useful?

Colon cancer screening: when is colonoscopy useful?

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What should be done to prevent colon cancer?

From the age of 50, statutory health insurers are entitled to an annual test for hidden blood in the stool to detect colorectal cancer. In addition, every legally insured person has two colonoscopes available for early detection. Experts from the German Cancer Research Center explain when these should best be carried out.

The German Cancer Research Center recently conducted an investigation to determine when the best time is to have a colonoscopy to reveal colon cancer at the earliest possible stage. The results were recently published in the specialist journal "The BMJ".

When should you have a colonoscopy?

The risk of developing colorectal cancer increases with age. Therefore, doctors recommend performing the first colonoscopy (colonoscopy) from the age of 50 in men and the age of 55 in women. As a rule of thumb, the second colonoscopy was performed ten years later.

Researchers checked the recommendations

Researchers at the German Cancer Research Center have now systematically analyzed whether this time interval should still be given as a recommendation. A systematic analysis showed that the ten-year period makes sense, but cannot be generally recommended. For some patients, other deadlines seem to make more sense.

Search for findings

"What was missing so far was a systematic examination of the detection rates of relevant findings in follow-up colonoscopy in order to determine the period after which a follow-up examination should be advised," explains prevention expert Hermann Brenner from the German Cancer Research Center. His team examined 28 individual colorectal cancer studies to determine the right time period.

How the distances affect the detection rate

Looking at the more clinically relevant advanced stages of colon cancer, the detection rates were 2.8 percent when the second colonoscopy was done after one to five years, 3.2 percent after five to ten years, and 7 percent after over ten years .

Conclusion of the study

According to the researchers, the rate of advanced cancer precursors remains at an almost constant low level for most of those affected up to ten years after the initial examination. The team concludes that after an inconspicuous first colonoscopy, the patient should wait at least ten years before a second colonoscopy. However, if there is an increased family risk, it makes sense to carry out the follow-up examination earlier.

May even wait longer than ten years

The study suggests that the follow-up investigation could be postponed even longer than ten years. So far, the study situation is too thin for a specific recommendation. (vb)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Graduate editor (FH) Volker Blasek


  • Thomas Heisser, Le Peng, Korbinian Weigl, u.a .: Outcomes at Follow-Up of a Negative Colonoscopy in the Average-Risk Population: A Systematic Review and Meta-Analysis, BMJ, 2019,

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