Colonoscopy—does the word make you wince? The consequences of avoiding the procedure are much scarier. Among cancers that affect both men and women, colorectal cancer is the second leading cause of cancer-related deaths in the United States, but patients have the collective power to change that statistic.
Colonoscopies save lives by finding precancerous polyps, which can be removed years before cancer develops. Medical guidelines recommend both men and women have colonoscopies every 10 years beginning at age 50 or at age 40 if there is a family history of colon cancer.[1] However, according to the Centers for Disease Control and Prevention, almost a third of U.S. adults are not up-to-date for their colorectal cancer screening.[2]
As a diagnostic radiologist, I know that many patients delay screenings because of the unpleasant nature of traditional screening methods. Patients should know that medical advances in recent years have improved and expanded options for screening procedures and preparation.
Bowel preparation is often times the most unpleasant aspect of undergoing colonoscopy. However, liquid laxative preps are now easier to tolerate than in the past. With regards to the actual procedure, patients are sedated, which makes it painless, and the use of carbon dioxide over room air to inflate the colon results in less bloating and cramping afterwards.
Colonoscopies are safe, but as with any procedure, patients should always discuss the risks and benefits of a colonoscopy with their doctor. If patients cannot undergo conventional screening or have a history of unsuccessful conventional colonoscopies, there are other methods available for colorectal cancer screening.
CT virtual colonoscopy is a reliable, less invasive alternative for patients who cannot or choose not to undergo conventional screening. During virtual colonoscopy, patients lie on a padded scanner table, and a small tube is inserted to inflate the colon. The table slides into the scanner so that images may be captured of the colon. This is repeated twice, once while faceup and once while facedown. CT scans produce a three-dimensional image that will show any abnormalities. If polyps are detected, patients can have them removed during a traditional colonoscopy. Some small polyps depending on circumstances can be followed with repeat CT virtual colonoscopy in lieu of biopsy. CT virtual colonoscopy takes about 10 to 15 minutes and is generally recommended every five years.
Whether virtual or traditional, anyone scheduled for a colonoscopy should ask questions so that they know exactly what to expect. Patients who are more educated about the procedure typically experience less nervousness. It is also important not to let embarrassment or stories of other people’s colonoscopies increase your own anxiety.
I encourage
all adults to discuss their risk, anxieties and testing options with their
doctor. It is a conversation that could save
your life.
[1] Fairfax Radiology. CT Virtual Colonoscopy. https://www.fairfaxradiology.com/procedures/low-dose-computed-tomography-ct/ct-virtual-colonoscopy. Accessed June 15, 2019.
[2] Centers for Disease Control and Prevention. Quick Facts, Colorectal Cancer Screening in U.S. https://www.cdc.gov/cancer/colorectal/pdf/QuickFacts-BRFSS-2016-CRC-Screening-508.pdf. Accessed June 15, 2019.
