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Catching colorectal cancer at an early stage improves survival rates tremendously. You have to weigh the risk of complications from the colonoscopy (primarily bowel perforation) with the improved outcomes. There's a cost element as well, since colonoscopies (without complications) can be several thousand dollars.

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That's the calculations that go into screening guidelines. It's a lot of weighing now much benefit early detection provides vs how much harm testing and false positives do.

Guidelines do change however. When I first was diagnosed at age 41, my doctors were all pretty surprised due to my age. Not shocked, just surprised. Five years later, they were all pretty consistent in their views that the age guidelines should be lower, and that viewing colorectal cancer as something primarily limited to 50+ was outdated.

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