When do you need a colonoscopy? An article in Annals of Internal Medicine in May of 2012 stated that there's insufficient evidence to recommend earlier or more frequent colonoscopies for people who have a first degree relative with a precancerous polyp unless the polyp is advanced. About 30-50% of people have polyps that are precancerous, but only 5-10% warrant more frequent colonoscopies. The US Preventive Services Task Force recommends the same, but the American Cancer Society and the American College of Gastroenterology recommend an accelerated screening program. The financial conflicts of interest of the ACS and ACG likely are responsible for this position in my opinion. However, although it is doubtful, it is also possible that another reason for this difference of opinion is related to their concern to provide optimal screening. Colonoscopy is associated with potentially serious bleeding or possible perforation of the gut in 1 of every 200 procedures.
