Health take-away: Prevent colon, rectal cancer with one test
"That wasn't so bad."
This is the most common reaction I hear from patients when I meet them in recovery after a colonoscopy. Next comes expressions of great relief to learn that their results were clear, or that a polyp was found and removed before the potential of developing into cancer down the road. Still, people tend to think of every excuse possible to put off a 15-to-20-minute procedure that can save their lives.
True, you will lose a day of work. It's also true that preparing for a colonoscopy is unpleasant, though the process has improved over the years. But the greatest truth is that a colonoscopy is considered the gold standard when it comes to detecting colon or rectal cancer in their earliest and most treatable stage. The American Cancer Society counts a million people who are alive today because they stopped making excuses and scheduled this screening test.
Men and women are almost equally at risk for the disease, while African American men and women are diagnosed with colon or rectal cancer at higher rates. If found and treated early, the five-year survival rate is about 90 percent. Tragically, less than half of colon or rectal cancer patients are diagnosed at this stage, when treatment is most likely to be successful. This alarming statistic brings us back to colonoscopies — the screening test that can save your life.
During the procedure, your physician will be on the lookout for a polyp — a small growth that can eventually lead to colorectal cancer. They typically don't cause symptoms, but they can eventually turn deadly. Polyps can be removed during a colonoscopy, stopping a potential cancer in its tracks. It's common to find a polyp during a colonoscopy, and some of the time, they are not the kind that will lead to cancer. But often enough, we find pre-cancerous polyps — even in people with no family history of the disease — and know our patient just received a new lease on life.
The vast majority of patients receive sedation that keeps them unaware of what's happening during the procedure. You will need a ride home from the hospital after a colonoscopy and may want to take a nap. Most people feel just fine within a few hours.
Without a doubt, the biggest reason why people fail to schedule a colonoscopy is the preparation, which involves drinking a liquid laxative the night before and morning of a colonoscopy. There's no getting around the fact that you will spend a lot of time in the bathroom. A clean bowel provides your physician with the most optimal environment to detect and remove polyps. It also helps to keep in mind why you are doing this in the first place — to protect your health. Ninety percent of the time, colorectal cancer is diagnosed after age 50, which is why we recommend that your first colonoscopy be scheduled around your 50th birthday. If your screening is clear and no polyps are found, you most likely will not need another screening test for 10 years. Your primary care physician can help you assess your risks for colorectal cancer, and determine a screening schedule that is right for you.
I've had a colonoscopy. I understand why we dread preparing for the test. Yet, I've also experienced the extreme relief of knowing that I am safe from colorectal cancer and it's a great feeling. My first reaction when it was all over? It just wasn't all that bad.
Jeffrey St. John, MD is a gastroenterologist and Division Chief of Gastroenterology at Berkshire Medical Center
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