It may be one of the most dreaded cancer screening tests, but most people don’t even remember it when it’s all over. Colonoscopy can not only diagnose but prevent colon cancer, making it one of the best cancer-fighting tools available.
“Our goal is to make sure everyone gets screened,” says Dr. David Goran, medical director of gastroenterology services at Barnes-Jewish West County Hospital. Everyone should have a colonoscopy at age 50, and screening may begin sooner if a patient has a family history of colon cancer, he says.
An individual who has a normal colonoscopy at age 50 doesn’t need to be tested again for 10 years unless symptoms such as rectal bleeding, persistent abdominal pain, a significant change in bowel habits, or rapid and unintended weight loss occur.
In 100 consecutive colonoscopy patients that Goran tabulated, 45 had colon polyps removed during the procedure, but this doesn’t necessarily mean that 45 percent of the population has polyps—or even 45 percent of the screened population. Polyps are abnormal cells that grow on the wall of the colon, explains Dr. David Lotsoff, a gastroenterologist and endoscopist at the Endoscopy Center of St. Louis. And he should know; Lotsoff acts as ‘Polyp Man’ at educational health fairs, answering questions and urging people to get screened.
“Polyps can be precancerous, but we can remove them during the colonoscopy, so in effect we’re preventing colon cancer,” he says. Patients who have polyps removed typically return for another colonoscopy in three to five years, although each case is different and recommendations depend on several factors, such as the number and size of polyps, as well as family history.
As for the exam itself, “One area of improvement is in bowel preparation,” says Dr. Jeff Kreikemeier, a gastroenterologist with Gateway Gastroenterology and the Midwest Endoscopy Center. “We, as gastroenterologists, have options for bowel cleansing. For example, some practices, like ours, utilize a Gatorade/Miralax combination, which seems to be more palatable for patients and therefore often leads to a better result,” he says.
For the procedure, patients are sedated, allowing the physician to insert a long, flexible, lighted tube, called a colonoscope, into the anus and slowly guide it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the physician a better view. A small camera mounted on the scope transmits a video image to a computer screen. Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again. The whole procedure usually takes about 30 minutes.
Kreikemeier says the most important message he can share is: “Get screened—it could save your life! Then tell friends and family about your experience because the more that people talk about colonoscopy and colon cancer screening, the less likely others will be to shy away from the procedure, especially when they hear how easy a colonoscopy is.”