Colonoscopy Concerns? Take a Friend With You

Hardly a week goes by that I don't hear about someone losing the battle to colon cancer. And each and every time I ask how this could happen, when today we have the ability to diagnose colon cancer years before it will spread -- and often in a precancerous polyp stage.

Why weren't they screened for colon cancer? Didn't they know the statistics? Except for lung cancer, which is usually caused by smoking and diagnosed in late stages because there are no reliable early screening tests, colon cancer is the leading cause of cancer death in men and second only to breast cancer as a cause of cancer death in women.

While it's tempting to simply avoid getting checked for colon cancer -- and surveys show that less than half of us are getting checked because of what many patients refer to as the big "hassle factor" -- the feeling of relief after being tested and the assurance you have done all you can to prevent this disease is tremendous after the exam.

I am proud to say that I have had my colonoscopy so I can speak directly from experience. The hassle of being checked is well worth the peace of mind.

Screening Recommendations

Last week the U.S. Preventive Services Task Force updated its 2002 recommendations on colorectal cancer screening. The group is emphatic that standard colonoscopies should be performed every 10 years, beginning at age 50 and continuing until age 75. Additionally, the group recommends a stool sample test for hidden or microscopic blood be performed each year starting at age 50.

The task force recommends against routine screening for adults 76 to 85 years old, unless doctors feel that the patient's personal history warrants it. They make this recommendation for our oldest seniors because current research shows that, in this age group, finding an early polyp or precancerous or even cancerous problem is unlikely to change the ultimate outcome.

It is thought that many older seniors will die sooner from heart disease or another problem long before any colon problem will be evident. However, if you are a healthy 80-year-old with no serious health problems, talk to your doctor about getting screened.

After age 85, the task force recommends that no screening for colon cancer (or other cancers for that matter) should be done, because research suggests that the risks outweigh the benefits in our very oldest seniors.

Virtual Colonoscopies

The U.S. Preventive Services Task Force, unlike the American Cancer Society, does not recommend virtual colonoscopies over the traditional approach. The group emphasizes that despite recent studies showing some possible benefit, more research is needed.

Yet many people are now talking about getting this newer X-ray test in hopes of: 1) avoiding the bowel preparation they have heard so much about (even though a completely empty bowel is still needed so the preparation/liquid drink can't be avoided); and 2) avoiding the anesthesia required for the colonoscopy. (You do avoid the anesthesia, but the installation of air to keep the bowel wall open during the exam can be uncomfortable.)

And to complicate things further, if your doctor finds a small polyp or abnormality on the virtual X-ray test, you will need to take the bowel preparation all over again and return for the standard colonoscopy. Only during the standard colonoscopy can your doctor take a biopsy of a suspicious area or remove a polyp.

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