Colorectal cancer is the third most commonly diagnosed cancer and the second leading cause of cancer deaths in the United States. The American Cancer Society estimates that 135,430 people will be diagnosed with colorectal cancer, and 50,260 will die from this disease this year. Colorectal cancer affects an equal number of men and women. Most of these cancers can be prevented by colon cancer screening with colonoscopy.
People may fear a screening colonoscopy for many reasons, however, this simple, painless test could save your life. To help ease fears and encourage preventative care, Dr. David Lichtenstein answers some common questions about colonoscopy screenings:
What is a colonoscopy?
A colonoscopy is an imaging test of the colon (large intestine). It’s an outpatient procedure, meaning patients do not stay overnight at the hospital. The test itself is usually 20 to 30 minutes in length and is performed in a dedicated specialty area of the hospital called the endoscopy unit. Throughout the colonoscopy, patients are given intravenous medications that makes them sleepy and relaxed. A thin, flexible device is navigated through the colon and allows your doctor to see the lining of the colon. Colonoscopy may detect polyps (small growths on the lining of the colon). Removal of these polyps is painless and results in a major reduction in the likelihood of developing colorectal cancer.
Who needs to have a colonoscopy?
Typically, patients should start having colorectal cancer screening with colonoscopy at age 50. Sometimes, however, there are circumstances where patients may need to have a colonoscopy sooner. This may include experiencing bleeding with bowel movements, symptoms of an underlying gastrointestinal condition like ulcerative colitis or Crohn’s disease, or a family history of colon cancer.
If there are no underlying conditions or symptoms, then it’s recommended that patients undergo colonoscopy once every 10 years beginning at age 50.
What is my provider looking for when they do a colonoscopy?
If you are at normal risk for colon cancer (age 50 or older, no family history, no obvious signs or symptoms) then your colonoscopy will be to screen for colon cancer and be proactive about your health.
If you are experiencing symptoms that may suggest an underlying disease, then a colonoscopy can reveal the source of tummy pain, rectal bleeding, constipation, diarrhea, and other gastrointestinal issues.
If you have a history of polyps, you may need additional colonoscopy screenings to look for more polyps, or to remove them if your provider thinks they may put you at risk of getting sick.
How do I prepare for a colonoscopy?
In order for the colonoscopy to be efficient, the provider must be able to see all areas of the colon. This requires that the colon be emptied before the procedure. Patients are asked to carefully follow the colonoscopy preparation instructions, which includes drinking a prescribed beverage to clear your colon.
Are there risks associated with having a colonoscopy?
A lot of patients assume that a colonoscopy is complicated or painful, but the reality is that for most, colonoscopies are a completely painless procedure that's done at different sedation levels, from a moderate level for comfort to deep sedation for patients who may want to be completely asleep for the procedure. It's uncommon to experience pain during or after the procedure.
As with any medical procedure there are some potential risks. These unlikely complications may include, an adverse reaction to the medication for sedation, bleeding, or tears. Patients are closely monitored throughout the procedure by their care team.
What if my screening reveals abnormal results?
Sometimes during a colonoscopy, your provider will remove polyp growths. If the polyps are small or non-cancerous, the removal usually eliminates the risk of that particular polyp growing into colon cancer. Patients with polyps may need a follow-up colonoscopy sooner than 10 years to make sure no additional polyps have grown.
If you are diagnosed with colorectal cancer, surgery is generally required to remove the cancerous tissue. The type of surgery and follow-up treatment will depend on the type, location and extent of the cancer. In the past, a colostomy was usually necessary. However, new surgical techniques can eliminate the need for a colostomy in many patients.
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