my primary care clinic sends its patients a mail in FIT test kit each year. Any abnormal results are followed up by invasive testing.

The possible adverse outcomes of the colonoscopy procedure are not properly disclosed to patients and the actual impacts, such as perforations, diverticulitis, infections and some cardiovascular events don't show up until as much as weeks later.

The scopes are cleaned after use but they are not 100% free of the bacteria from prior users. The scope and the aggressive laxatives used to empty the bowel remove most of the 3-4 pounds of protective bacteria in the lining of the colon, leaving the colon open for infection from yeast, pathogenic bacteria or material left on the scope from a previous procedure.

I realize that this is a very personal decision and that many people have been saved by the procedure. At my age I'm taking the less invasive approach unless the annual FIT results call for the next step.