At what age should a person with a first degree relative who had colorectal cancer or adenomas after age 60 start screening with colonoscopy?

The recommended age to start screening with colonoscopy for individuals who have a first-degree relative with colorectal cancer or adenomas diagnosed after the age of 60 is 40 years. This guideline stems from the understanding that individuals with a family history of colorectal cancer are at an elevated risk for developing the disease themselves. Specifically, the screening protocol suggests that such individuals begin their screenings at a younger age than the general population, which typically begins at 50 years of age.

In this scenario, because the relative's diagnosis occurred after age 60, this supports the notion that the risk of developing colorectal cancer may not be as high as it would be if the relative had been diagnosed at a younger age, allowing for screening to start at 10 years earlier than the standard recommendation for average-risk adults. Therefore, age 40 is the appropriate starting point for monitoring and early detection through colonoscopy in this specific context.