Colonoscopy: Saving lives

A colonoscopy is one of those medical screenings we know we should have once we hit the half-century mark in age, but it’s easy to find reasons to put it off.

The best way to get past that? Repeat this mantra: “It could save my life.”

Every year, more than 150,000 people in the United States are diagnosed with colon or rectal cancer and more than 50,000 die. Because many people feel nothing unusual during the early stages, colonoscopy is the best way to look for the disease and its earliest signs.

 

Dr. Richard Hell

Dr. Richard Hell, chair of internal
medicine at Community Hospital

“Colon cancer closely follows breast cancer among cancers in women; and it is the second-leading cause of cancer related deaths, behind lung cancer, when both sexes are combined,” says Monterey gastroenterologist Dr. Richard Hell, chair of internal medicine at Community Hospital. “The incidence of prostate cancer is significantly higher than colon cancer in men, but the percentage of those who will die from it is less than colon cancer. Colon cancer is a killer.”

Screening is a lifesaver.

“Colonoscopy is important not only to screen for cancer,” Hell says, “but also to look for polyps or growths in the lining of the colon that can turn into cancer. Not all polyps turn into cancer, but because some do, we remove the polyps as we find them during the colonoscopy.”

Preparation for the procedure begins the day before and involves limiting the diet to clear liquids and ingesting two doses of laxative several hours apart to empty and clean the colon and rectum.

The test is an outpatient procedure.

The patient typically is sedated before the gastroenterologist inserts a thin, flexible, lighted tube, or colonoscope, into the rectum and colon. That enables the doctor to look at the lining of the colon, take pictures, and see whether there are polyps that need to be removed. The colonoscopy usually lasts about 30 minutes, possibly longer if polyps are removed.

An alternative procedure is the virtual colonoscopy, which uses computed tomography — a CT scan — to enable a radiologist to see the interior of the colon in a three-dimensional computer image. However, the procedure is not covered by most insurance companies; and if a polyp is detected, the patient must undergo a conventional colonoscopy to have it removed.

“If a polyp is removed, it is sent to a pathologist for review under a microscope,” Hell says. “The results usually come back in four to five days.”

The incidence of colon cancer increases with age, particularly after 50, so the American Cancer Society recommends people with no family history of the disease have their first screening then.

If no issues are found, the test should be repeated every 10 years. If you have a family history of the disease or other risk factors, talk to your doctor about when to have your first screening and how often it should be done.

Risk factors for colorectal cancer

Risk factors that may increase a person’s chance of developing colorectal polyps or colorectal cancer include: 
 
AGE: 9 out of 10 people diagnosed with colorectal cancer are older than 50. 
 
HISTORY: Personal history of colorectal polyps, colorectal cancer, or inflammatory bowel disease. Family history of colorectal cancer.  

LIFESTYLE: Obesity, lack of exercise, diet high in red and processed meats and low in fruits and vegetables, smoking, and heavy alcohol use.  

SOURCE: American Cancer Society