I have to respond to and correct the recent article and podcast about a doctor having his first colonoscopy in his late 60s without anesthesia. There were multiple factual errors and misstatements by the doctor author, which may well dissuade doctors and laypeople from colonoscopies in the future.

First, he notes the reason he’s thus far not had a colonoscopy: he has no family history, and he’s athletic and overall in good health. A layperson hearing this will intuit that if they also have no FH of colorectal cancer (CRC) and exercise this physician does, they can also forgo the screening. This is dangerously ignorant – the fact is that the vast majority of new cases of CRC in the U.S. are found in patients with absolutely no FH of the disease. Exercise also plays little role in risk, at least individually. Like me, every gastroenterologist I know has found CRC in vegetarian marathon runners and similar people.

Second, he recommends that those over 50 get screened; the current U.S. guidelines from every society, including the American College of Gastroenterology, the USPSTF, and the AAFP, recommend starting at age 45.

Third, while having a colonoscopy without sedation is done, it’s generally a bad idea. I’ve done over 20,000 procedures, about half a dozen of which were unsedated. I always try to dissuade patients from doing this. At least 1/2 of the patients who try ask us to abort the procedure since they’re having too much discomfort and don’t have a ride home if we then gave them anesthesia. Typically the patient will also try to talk to the doctor about the procedure while it’s happening, which distracts us from this careful examination: Is that a good idea?

Lastly, sedation has no downside besides needing a ride home, especially with propofol. Our center has done over 100,000 procedures in the last ten years with no anesthesia-related complications. With a good anesthesiologist or CRNA, it’s incredibly safe.

Get anesthesia; get it done at 45 or at least 50. And get it done no matter how healthy you are, if you’d like to remain that way.

David Neiblum is a gastroenterologist.