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âIf you have a first-degree relative with colon cancer, exams should start between ages 35 and 40,â says Fuchs. Colonoscopy is the most reliable test, because doctors can visually study the entire colon and rectum, Fuchs says.
1 It depends on your risk. 2  If you are 50 years or older with no family history or personal history of polyps or cancer, then the first colonoscopy should be at 50. 3  If you are African American, your screening colonoscopy should start at age 45. 4  If that is normal, you should have one every eight years afterward. If you are 50 years or older with no family history or personal history of polyps or cancer, then the first colonoscopy should be at 50. 2  If you are African American, your screening colonoscopy should start at age 45. 3  If that is normal, you should have one every eight years afterward.