I have UC and will get colonoscopies to confirm it is well-controlled for the foreseeable future. It also increases risk of colorectal cancer, something I am actively thinking about. Rates of UC, IBD, and similar digestive issues are up across the board, also for a mixed and seemingly inscrutable set of reasons.

IMO, the fundamental issue for preventative screening is there is basically no amount of money I would not part with (of my money, the insurer's money, or private debt) to not die. I expect this is true for most people, and it makes preventative screening a tricky topic. In recommending screening for those >x age, you will miss some detectable, preventable and treatable cancer risk for those <x age, purely for cost. No one wants to be explicit about that though!

I think the only way out of that uncomfortable conversation is making screening so cheap via automation that you can basically run it for very low incremental cost as often as individual risk tolerance permits. This would be paid for on the back of earlier interventions vs late-stage, expensive interventions.