The Colonoscopy Conundrum - PIH Health

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Published on December 05, 2016

The Colonoscopy Conundrum

Doctor speaking with patient about a colonoscopy

Of all the medical tests and procedures that are recommended for adults, the colonoscopy is arguably one of the most misunderstood and the most feared. Many people have concerns about preparing for the procedure as well as fears about the procedure itself. However, when asked, patients who have had a colonoscopy say that the preparation wasn't that bad and the procedure itself was easy because they were sedated.

Even though patients may have concerns about having a colonoscopy, it is the most valuable tool for preventing any form of colon cancer. “By understanding how effective a colonoscopy is in preventing colon cancer and saving lives, people will usually put aside their concerns and reservations and undergo this life-saving procedure,” said Neal Shindel MD, a gastroenterologist at PIH Health.

Dr. Shindel says that it is important for everyone to understand some very basic concepts about colon cancer and colonoscopies:

  • Approximately 40 to 50 percent of adults over the age of 50 have polyps growing silently in their large intestine (this includes the colon and the rectum).
  • Polyps are benign (non-cancerous) growths that develop on the inner lining of the colon wall. They start small and grow slowly, but have the potential to turn into cancer.
  • It is estimated that it takes between five and 15 years from when a polyp begins to grow and when it turns cancerous.
  • A colonoscopy is a procedure that allows a specialized physician (a gastroenterologist) to examine the entire large intestine with a flexible, lighted video scope. During the colonoscopy, almost all of the polyps that are found can be removed.
  • Most importantly: Removing polyps helps remove the risk of colon cancer developing. In fact, studies have shown that colonoscopies reduce colon cancer deaths by as much as 90 percent!

Because early detection of colon cancer is so important, Dr. Shindel would like to clarify the guidelines for screening. Individuals are considered to be at average-risk if they have no personal or family history of colon polyps or colon cancer and no personal history of ulcerative colitis or Crohn’s disease. For these patients, both men and women, screening should begin at age 50. If no precancerous polyps are found, a follow-up colonoscopy is recommended every 10 years.

An individual is considered to be high risk if they have a personal or family history of colon polyps or colon cancer. Those who are considered high-risk should start being screened at age 40 or 10 years earlier than the youngest family member with a history of colon cancer. In addition, patients with ulcerative colitis or Crohn’s disease also need more aggressive screening and should speak with their gastroenterologist about when they should start.

Given the widely varied family and patient histories, there is not a single screening approach that is right for everyone. Your medical and family history will play a major role in determining the screening prevention and frequency plan that works best for you.

Though there are different options available, colonoscopy is the most effective screening option available. “Colonoscopies are the gold standard for colon cancer prevention and early detection,” said Dr. Shindel. “If you are age 50 or older and have not had a colonoscopy, it’s time to get screened.”

If you would like additional information or would like to schedule a colonoscopy (a referral from your primary physician is not required by most health plans), call the PIH Health Colon Cancer Prevention Program at 562.945-4754.

The information in Healthy Living Online is for educational purposes only.  It is not intended nor implied to be a substitute for professional medical advice.  The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation, or if they have any questions regarding a medical condition or treatment plan.

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