Colonoscopies can – and do – save lives
Doctors say fear of procedure's prep keeps too many from exam
Monday, March 4, 2013
- I follow doctors’ orders and get regular screenings. 58%
- I get screened, but it’s not a priority. 22%
- I have to get screened for cancer? 6%
- I don’t have insurance or can’t afford screenings. 12%
- I’m too young to worry about cancer. 2%
105 total votes.
Gastroenterologists might have found one thing people dread more than root canals: colonoscopies.
The prep may be unpleasant, but the procedure can save lives and even prevent cancer.
"Not only can you prevent a person from dying from colon cancer, you can actually prevent them from ever getting colon cancer," said Dr. Jason Etzel, a gastroenterologist at The Vancouver Clinic's 87th Avenue clinic.
Colon cancer is cancer of the large intestine, or colon, which is the lower part of the digestive system. Rectal cancer is cancer of the last several inches of the colon. Together, they're often referred to as colorectal cancer.
Colorectal cancer is the third most common cancer in both men and women, according to the American Cancer Society. In 2012, an estimated 103,170 cases of colon and 40,290 cases of rectal cancer were diagnosed in the U.S., according to the group.
"It's a common disease, unfortunately, for both men and women," Etzel said.
The incidence rate has been declining for most of the past two decades — a decline that's been largely attributed to an increase of colorectal screening, according to the cancer society.
Still, colorectal cancer has an "abysmal" screening rate — only about 30 to 40 percent of adults of screening age, 50 years old, actually get tested, Etzel said.
The biggest reason people avoid the tests is because of the unpleasant prep, said Dr. Son Do, a gastroenterologist at Advanced Gastroenterology in Salmon Creek.
"They don't want to do it because they hear from friends that it's a horrible procedure, mainly because of the prep," Do said. "They only remember the prep, not the procedure."
The most common method of colorectal cancer screening in the U.S. is colonoscopies.
In the 24 hours prior to a colonoscopy, the patient must drink a significant amount of liquid laxative (sometimes up to a gallon) and not eat solid foods to clean the colon. During a colonoscopy, gastroenterologists use a flexible tool with a camera and light to exam the entire colon wall for polyps. Patients are sedated during the procedure.
Polyps are benign tissue growths in the lining of the colon, Do said. The polyps start out as small, pimplelike bumps but will continue to grow and can become cancerous, he said.
Typically, gastroenterologists will remove polyps during the colonoscopy and have them tested for cancer. Removing the polyps prevents them from becoming cancerous down the road, Do said.
In addition to prevention, colonoscopies are a method with which gastroenterologists detect cancer. If cancer is found, the patient has surgery to remove the tumor. After healing from the surgery, people can resume their normal lives, Do said. If the cancer is more advanced, the patient might also need chemotherapy or radiation, he said.
Colorectal cancer does have symptoms — including bloody stool, new onset of abdominal pain, change in bowel movements and ongoing diarrhea — but the precancerous polyps do not have symptoms. That's why screening is important, Do said.
Colonoscopies are recommended for normal-risk men and women once they reach age 50. A person is considered "normal risk" if he or she does not have any symptoms, does not have a family history of colorectal cancer and does not have a personal history of cancer or polyps.
If no polyps are found, colonoscopies are only needed once every 10 years. The interval is shorter for those who have polyps.
"Colon cancer is, of all the cancers out there, the most preventable," Etzel said.