I had the most common symptom of colon cancer in my early 30s. Here's why I got a (pricey) colonoscopy over a stool test.

PonyWang/Getty Images
- I had rectal bleeding, the most common symptom of colon cancer in people under 45.
- I also had a family history of colon cancer, which pushed me to get a colonoscopy at 33.
- My out-of-pocket colonoscopy cost is over $1,000 so far, but I'm still glad I did it.
I paused, then clicked "cancel appointment."
The blood in my stool, the most common sign of colon cancer in young people, was going away. I chalked up my concerns to my job: I was interviewing colon cancer patients. Naturally, the symptoms were on my mind a lot.
But a year later, the bleeding kept coming back, and more prominently than before. Sometimes, I also had other colon cancer symptoms, like inconsistent bowel movements. From writing more about colon cancer, I heard more stories of healthy young patients having barely any warning signs, only to be diagnosed at stage 4. And then, my grandfather was diagnosed with stage 1 colon cancer in late 2024.

Julia Pugachevsky/ZocDoc
I still had reservations about getting a colonoscopy. It seemed expensive and intense for just one symptom. At the same time, that symptom seemed to be getting worse after a year, and I now had a family history of colon cancer.
In the end, I got a colonoscopy and am so glad I did β even if I'm still navigating the financial side of it.
Colonoscopy or stool test?
I booked a GI appointment after reading about stool tests, which can detect cancer via stool samples. It seemed minimally invasive while still taking some sort of action.
At my appointment, I'd hoped my age, lifestyle, and lack of more severe symptoms like abdominal pain would sway her to recommend the stool test over the colonoscopy.

Cologuard
However, stool tests aren't considered the gold standard of colon cancer screenings because they can only detect cancer. It was possible that I had precancerous polyps, for example, which wouldn't show up in a stool test but could be safely removed and biopsied in a colonoscopy. Plus, colonoscopies can identify other colon-cancer-like issues, such as hemorrhoids or IBD.
My GI performed a quick rectal exam and didn't find anything. She said that given my age, the bleeding was likely caused by internal hemorrhoids or polyps, not cancer. She recommended I get a colonoscopy and some blood work to test my iron levels, which could also point to colon cancer. I booked a colonoscopy for three weeks later.
I was worried about the cost and intensity of the procedure
When my blood work came back normal, I wondered if I was overreacting. Did I really need a colonoscopy?
For one, it was expensive. The procedure would cost $2,000 total without insurance. My GI explained that because my test was diagnostic and being done to examine colon cancer symptoms (as opposed to a standard colon cancer screening), it applied to my deductible. She also said that the cost can vary based on my insurance plan, how far into the deductible I am, and where the colonoscopy is being done. Because I did mine at a free-standing endoscopy center instead of a hospital, it cut down on costs.
The estimate I got from my insurance company was around $813. That didn't include other potential fees like biopsies. This is still lower than the national average cost for a colonoscopy, which starts at $1,250, and some of my coworkers under 45 were quoted closer to $2,000.

Julia Pugachevsky
The idea of the procedure itself felt intense, too. I'd need to fast and take about $40 of laxatives and Gatorade the night before, undergo anesthesia, and have my husband pick me up. There were also very rare risks, like tears to my colon.
A few times a week, I'd approach my husband forlornly, asking him if he thought I was overreacting and should skip the procedure. Sadly, I learned the hard truth: no one could make this decision but me.
Postponing would be complicated, given our future plans to have kids: I can't get a colonoscopy once I'm pregnant because of risks to the fetus.
I realized that I was fortunate: I had time to pre-plan and budget my colonoscopy, I could easily take a sick day from work, and my husband could take a few hours off from his job to pick me up. If I was going to do it, now was absolutely the best time.
I'm glad I did it, but insurance is a pain
Let's start with the bad news: months after the procedure, I'm still dealing with insurance costs.
I made sure that my FSA funds, the pre-tax money I elected to set aside for medical costs, would cover at least most of the procedure and any extra fees. But because my receipt was missing information, the reimbursement for $813 was denied.
When I asked for a complete receipt, I was told I'd need to wait 30-60 days for my insurance to process my itemized statement. While I was waiting, I was mailed two more bills; $124.08 for a physician's processing fee and $125.40 for the anesthesia.

Julia Pugachevsky
I'm holding on to them until I get reimbursed for the $813. Otherwise, I'd be paying over $1,000 out of pocket, with no clarity on when I'll actually get the money back, if at all.
I finally had answers for my symptoms
The good news: the colonoscopy itself went smoothly. Sure, induced bowel cleansing wasn't my idea of a riveting Wednesday night. But from speaking to multiple people who've had colonoscopies, it sounds like it wasn't as unpleasant as chugging Golytely, a common colonoscopy prep medication.
The actual procedure took about 20 minutes, all of which I was out for.
Shortly after, my GI popped in to explain my results. It was a huge relief to have answers. Like she suspected, internal hemorrhoids, swollen veins in the anus and lower rectum, were causing the bleeding. Hemorrhoids are fairly common in young people, and activities like lifting heavy weights could cause them. Looking back, the bleeding began around when I started strength training, and my GI confirmed that it could exacerbate the hemorrhoids. I can manage them by drinking more water, eating more fiber, and using hydrocortisone cream.
She also found and removed two polyps, one of which could be precancerous because of its size. A few weeks later, a biopsy confirmed that the polyp was benign, and I don't have to get another colonoscopy until I'm 45 β the recommended starting age for colon cancer screenings.
As the rate of colorectal cancer rises among young people, there is a push for people to get their colon cancer symptoms checked out. But I can understand why anyone under the recommended screening age would skip a colonoscopy. Beyond the financial obstacle, it's not a quick procedure and requires a support system. It's easy to feel like the potential downside β spending time and money for a benign result β isn't worth the peace of mind.
Still, so many early signs of colon cancer are mild. Stories from colon cancer patients β the ones who only got diagnosed in late stages and had to navigate much more invasive treatments with lower odds of success β ultimately taught me that it's never worth taking a chance. It's a steep price to pay, but I'm glad I did.