Colonoscopy: In this test, a small tube with a camera on the end is used to look at the length of your colon. Medications are often given during the procedure to relax you and to decrease any discomfort. The whole test usually takes about 30-60 minutes, but only about eight minutes to look at the whole colon.
If a polyp is seen, it can be removed during the test. One of the most important ways to make sure polyps or cancers can be seen is to have a clean colon; this is why you need to clear your bowels with laxatives the day before the exam.
Most doctors recommend colonoscopy as the best screening test, because it looks at the whole colon instead of just the lower part, and allows screening, diagnosis, and treatment of polyps and some cancers to happen in one step.
Common Concerns, and What To Do
Here are some common concerns about colonoscopy, and suggestions about what to do.
Pain: Talk with your physician about medications that are used for relaxation and discomfort. Many people wake up and don't even realize they had a colonoscopy, according to Dr. Lisa Boardman, associate professor of medicine at the Mayo Clinic.
Prep: Although the prep is not anyone's favorite thing to do, most people tolerate it well, and some people even feel better when they are "cleaned out," according to Dr. Roshini Rajapaksa, NYU gastroenterologist and author of "What the Yuck: the Freaky and Fabulous Truth About Your Body."
Financial: If you have insurance, it should help with the cost. If you don't, talk with your physician about payment plans or offices that may offer some reduced-price screening tests. If money is an issue, FOBT is the least expensive test to do.
Complications: These are rare in both sigmoidoscopy and colonoscopy, and decrease with an experienced physician doing the procedure.
Denial: Remember that even if you are nervous to learn that you have cancer, finding it earlier is better.
Needing a ride: Talk with your physician about support services that may be available if there is not someone to help you with getting home. Rides are not an issue for FOBT, or usually for sigmoidoscopy.
General "ickiness:" Your doctor is comfortable talking about your colon with you, and we hope that you feel more comfortable now too.
Other organizations recommend a few other options for screening tests, but your insurance may not cover them, and many experts feel that the three listed above have the best evidence. However, research continues and other stool or "virtual" tests may become better and more available in the future.
The most important thing to know about colon cancer is that it can be prevented. Talk with your doctor about how to choose the right screening test for you, and maybe, you can even bring it up with your family at the dinner table.