Imaging
Colonoscopy
Lower endoscopy · Colorectal screening
The most thorough screening tool for colorectal cancer. FIT is the simpler alternative — both are reasonable for average-risk adults.
What it measures
Direct endoscopic visualisation of the entire colon and terminal ileum, with simultaneous biopsy and polypectomy capability. Detects colorectal cancer and precancerous polyps.
Reference context
0 guideline sources
Adenoma detection rate is a quality marker for the endoscopist; ask about your provider's. A high-quality normal colonoscopy meaningfully reduces colorectal cancer risk for the following decade.
Population context — consult guideline targets below
Mechanism
Why moving this marker matters
Most colorectal cancers arise from adenomatous polyps over 5–10 years. Detection and removal at the polyp stage prevents cancer; detection at the early cancer stage substantially improves survival.
How to measure
The test, where to get it, when to repeat
Method
Bowel preparation the day before, then ~30 minutes of endoscopy under sedation. Most adults take a half-day off work for the procedure plus recovery.
Where
Hospital endoscopy units, dedicated GI clinics. Increasingly available privately for those who want sooner appointments.
Typical cost
Public: free for eligible cohorts. Private: €600–1,500.
Fasting
Required
When to test
USPSTF 2021
45–75Screening for adults 45–75; choice of FIT (annually), sigmoidoscopy + FIT, or colonoscopy (every 10 years if normal).
NICE / NHS BCSP
50–74FIT every 2 years from 50 (rolling out to 50–74).
ESGE 2020
10-year interval after a high-quality normal colonoscopy in average-risk adults.
Where to scan
Providers offering this imaging study
These providers offer the scan directly to consumers. You book and pay with them; the imaging report lives on their platform. Healicus is not in the clinical chain.
Healicus is not the provider. Your contract for the service is with whoever you choose. Links labelled Sponsored are paid affiliate relationships; unlabelled links are editorial reference only. See our disclosure for the full policy.
Context
Reading the numbers
Adenoma detection rate is a quality marker for the endoscopist; ask about your provider's. A high-quality normal colonoscopy meaningfully reduces colorectal cancer risk for the following decade.
Caveats
Procedural risks (bleeding, perforation) are real but rare (<1 in 1,000). Bowel prep is the most-disliked part for most patients.
Take to your physician
Worth discussing
- Whether family history or symptoms warrant earlier or more frequent screening.
- Whether FIT, sigmoidoscopy, or colonoscopy is the right modality for you.
- What your endoscopist's adenoma detection rate is — quality matters.
Sources
Cited literature
Edited by Carl Pöhl, MD · Healicus editorial
Last reviewed May 2026
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