Dear Dr. Roach: I am an 80-year-old male in excellent health. I’ve had a colonoscopy every five years following my first in my mid-50s, in which five benign polyps were found. I was told colonoscopies are not recommended for men after 75, but I could continue if I wanted. I kind of got burned out on them, though.

At my request, my general physician agreed that I could have an annual stool sample in place of a colonoscopy. I plan to do this indefinitely, assuming that five stool samples in a five-year period should have a pretty good chance of diagnosing what a colonoscopy would diagnose once every five years. If that’s not the case, I’ll continue the colonoscopies. What do you recommend? — R.L.

Answer: Colonoscopies continue to be the most accurate screening test for colon cancer, but there are some downsides. The preparation is uncomfortable, most people are sedated, and there is a small chance of damage to the lining of the colon. Stool samples, which can look for blood or colon cancer DNA (or both), are a reasonable alternative. The combination tests (such as Cologuard) have better accuracy than the standard fecal occult blood cards, but are still not quite as good as a colonoscopy.

When to discontinue colon cancer screening in an average-risk person remains controversial, with some authorities recommending 75 and others 80. Most authorities recommend against screening after the age of 85. These recommendations do not apply to high-risk patients, such as those with a history of colon cancer.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.