Many people cringe when their doctor recommends they get a colonoscopy after their 50th birthday. But the simple procedure can literally be a life saver. Colorectal cancer is the second leading cause of cancer death in the United States, affecting one in 18 people, but it’s largely preventable through screening and early treatment.
Colorectal cancer screening can cut a person’s risk of dying from the disease in half, yet about 40 percent of those who should get tested don’t do it. Colonoscopy gets a bad rap because people associate the procedure with a certain amount of humiliation and discomfort. But the reality is many patients won’t even remember the procedure and – if they get a clean bill of health – they may not need to have a colonoscopy for another 10 years.
Why screening is important
Most colon cancers originate from small, noncancerous (benign) tumors, called polyps. These polyps form on the inner walls of the large intestine. Some of them may grow into malignant colon cancers over time if they are not removed. Since the polyps typically cause no pain or problems, the best defense is to find them before they become cancerous and remove them, thus eliminating the chance they may become cancerous.
Screening can also discover colon cancer early, when treatment can lead to a cure.
Who should have a colonoscopy?
Everyone age 50 and older
Individuals with a family history of colorectal cancer or polyps
Those with a personal history of inflammatory bowel disease.
What exactly is colonoscopy?
Colonoscopy is a direct visualization of one’s complete colon and rectum all the way to the lower end of the small intestine via the use of a flexible, lighted camera called a colonoscope. The procedure allows the clinician to find polyps and remove them right then, preventing them from becoming cancerous.
If other abnormalities are suspected, the physician can obtain a sample of the tissue and test it for malignancy. If a region of diseased colon is found, it can be evaluated and treated before it becomes more problematic.
On average, 15 percent of women and 25 percent of men age 50 or older will have precancerous polyps detected on colonoscopy. Not everyone who has polyps will go on to develop colon cancer; however, removing potentially precancerous polyps will greatly reduce the risk.
What causes polyps?
Researchers are unsure what causes polyps. Having certain risk factors and engaging in some unhealthy behaviors are thought to make colonic polyps more likely.
You may have a higher risk if you have:
A family history of polyps or colon cancer
Previously had polyps
Had ovarian or uterine cancer before the age of 50.
Unhealthy behaviors that may contribute to the growth of colonic polyps include:
Lack of exercise
Eating a diet rich in fats.
What can I expect during a colonoscopy?
The day before your procedure you will drink a laxative preparation to clean the colon out.
Prior to the procedure, you will be given medications to relax you and block pain. You should feel very comfortable. Some patients may report feeling a sensation of pressure, but rarely pain. The sedative also affects memory, and many people have no memory of ever having the colonoscopy. In some cases, colonoscopy can be done without sedation. However, sedation helps make patients comfortable during the procedure.
When you awaken or the medication wears off, you will need a responsible driver to take you home. Your doctor will notify you of the results. If there are no polyps or other issues, you may not need another colonoscopy for 10 years.
Colonoscopy is a simple, potentially lifesaving procedure. There is no need to be afraid. Talk to your doctor about when you should be tested.
Noel C. Sanchez is a colon & rectal surgeon at Via Christi Clinic on Founders’ Circle.