The primary benefit from scheduling yourself for a colonoscopy is that a colonoscopy screening dramatically lowers your risk of developing colorectal cancer, the second leading cause of cancer death in United States. A colonoscopy is a 15-minute, preventative screening procedure which according to researchers can lower the risk of developing colon cancer by up to 80%. Without colonoscopy screening, your lifetime risk of developing colon cancer is approximately 1 and 25 if you are a man and about 1 in 20 if you are a woman. Approximately 55,000 people die from colon cancer in this country every year, and many of these deaths are actually preventable. In fact, colon cancer, while still very common, is the single most preventable cancer if you take action.
What is a colonoscopy and exactly how does it work?
When you have a colonoscopy, you are put under a light anesthesia (done in this manner, the procedure is actually painless), and the lining of the colon is examined with a flexible, thin high-resolution camera. Anatomically, the colon consists of the last 4 feet or so of your intestinal tract. The physician performing the colonoscopy examines the lining of the colon for so called ‘polyps.’ Polyps are small benign growths that arise from the lining of the colon. These polyps, while benign, can develop over time into colon cancers. In fact, we think virtually all colon cancer start off in this way as these benign polyps. Because the polyp ordinarily takes months or years to develop into a cancer, there is a window of opportunity to remove the polyp while still benign during the colonoscopy and therefore preventing colon cancer. This is the main benefit of a colonoscopy, ‘nipping the cancer in the bud’ by removing any benign polyps that are detected.’ Colonoscopy is considered the ‘gold standard’ for colon cancer detection and prevention; in other words, it is the most accurate technology we have available to detect and prevent colon cancer. Based on my own personal practice experience, I have very little faith in the so called ‘poop in the box’ test for colon cancer. Contrary to the initial claims the company who developed it made, this test misses too many precancerous lesions and, in my experience, I have found it to be falsely positive in dozens of patients I have seen who then the wound up having to have a colonoscopy anyway. So, contrary to the intense marketing claims for the test, I do not consider it to in any way comparable to colonoscopy and, even worse, may give people a false sense of security.
Who is eligible to get a colonoscopy?
If you are 45 or older, have a family history of colon polyps or colon cancer, if you are obese, or if you are having symptoms of blood or mucus in your stool, a change in your bowel habits or unusual abdominal pain, you likely need a colonoscopy to ensure that you do not have something going on. It is most important to understand that that most colon cancers PRODUCE NO SYMPTOMS; they are ‘silent,’ until they are detected, or they reach a late stage where surgery or more drastic measures are required. During the colonoscopy, when we remove the precancerous benign polyps, we have usually avoided any further, more involved treatments or procedures.
How do you get a colonoscopy?
Colonoscopies are mostly performed by specialists, almost always gastroenterologists and by some surgical specialists. Physician specialists who are experts in colonoscopy have usually performed thousands of exams and are very safe operators with very few complications. The exam normally takes about 15 minutes in experienced hands. It is painless. The results are available immediately or at least within a few days of receiving the biopsy results if polyps or other lesions are removed.
How is the cost of colonoscopy covered?
In many states, including Virginia, insurance companies are required to pay 100% with no deductible or co-pay for screening colonoscopies. This being said, depending on the situation, your insurance carrier and your individual plan, there may be gaps in coverage. Nonetheless, because of the obvious importance of preventing colon cancer, coverage for colonoscopy is generally excellent and often patients are not required to have a co-pay or use their deductible. If you do not have any insurance or your insurance has a high deductible or for some reason excludes colonoscopy as a covered procedure, my recommendation is to check around and see what the noninsurance, cash-based cost is for an office screening colonoscopy. In our practice, we often save patients in this situation hundreds or even thousands of dollars. Our patients are often surprised by how low the direct pay cost is. Incidentally, virtually all colonoscopies in patients under 65 years of age are done in the office as office procedures rather than at the hospital as outpatients.
How do you schedule your colonoscopy?
Call one of the GI specialists (you can find their names on the Internet or speak with your PCP or other people who have had the procedure done already or get a list of providers from your insurance company and let them know you are interested in getting a colonoscopy screening. My recommendation to you in selecting a provider is to find someone who has at least good reviews by their patients and a lot of experience performing colonoscopies. Experience usually translates into the number of procedures the doctor has performed and how frequently he or she does them and correlates with good quality procedures and safety. Again, if you are 45 or older (the age used to be 50, but now we are finding more colon cancer in younger patients so the threshold for screening has been lowered to 45 years old) or if you have any family history, bleeding pain symptoms mucus discharge or change in your bowel habits you should get yourself checked out as soon as you can. Time is of the essence. As previously noted, colon cancer is almost always starts as a small benign lesion (polyp) which can be treated/removed right at the time of colonoscopy without any further surgery or interventions.
March, 2023 is Colorectal Cancer Awareness Month. Colon cancer, while one of the most common cancers, is also the MOST PREVENTABLE . Experts recommend that you take the take seriously the advice of the American Cancer Society.
DON’T SIT ON COLON CANCER!