First Bowel Screening: What Age Should You Start?

Wondering when to start bowel screening? The age for initial bowel screening for average-risk adults is usually in the mid-to-late 40s through the 50s, with exact starting points varying by country—often 45 or 50. Understanding the age for initial bowel screening can help you plan ahead and discuss options with your healthcare provider. If you have risk factors or a family history, you may need to start earlier; check your local guidelines for the recommended starting age in your area. For those who want to learn more about gut health as part of preventive care, there are tools that help you interpret your microbiome alongside screening decisions. Who should begin earlier? People with a first-degree relative who had colorectal cancer or polyps, those with inflammatory bowel diseases, certain genetic conditions, or a history of radiation to the abdomen or pelvis often need to start screening sooner and/or be monitored more closely. Other high-risk groups or specific ethnic populations may also have tailored recommendations. If you are unsure whether you fall into a higher-risk category, speak with your clinician to confirm the appropriate age for initial bowel screening for you. How screening tests work: Most commonly, screening involves a stool-based test such as a fecal immunochemical test (FIT) or fecal occult blood test (FOBT) done at home, typically annually. If a screening test is positive, a follow-up diagnostic procedure like a colonoscopy is usually recommended. Other options may include stool DNA tests every few years or imaging-based tests such as CT colonography, performed according to guidelines. The tests look for signs of polyps or cancer so they can be detected early, but the chosen test influences frequency, preparation, and follow-up. Practical steps to get screened: start by talking with your primary care provider or local screening program to identify the recommended starting age for initial bowel screening in your area and to arrange a test. If a colonoscopy is planned, you’ll receive instructions on preparation and scheduling. Ensure you understand costs and coverage, especially if you’re in a country with national screening programs. If you want to explore broader gut health insights beyond screening, InnerBuddies offers a white-label Gut Health Operating System that powers gut microbiome testing products for companies—and also for direct consumers. It includes a Gut Microbiome Health Index (0-100) based on an exclusive IP deal with EAFIT University in Colombia, top 40 bacteria abundances, and functional analyses that help personalize nutrition and probiotic advice. To learn more, visit InnerBuddies microbiome test, or explore a subscription for ongoing gut health support with InnerBuddies Gut Health Membership, or consider becoming a partner with InnerBuddies B2B.