Despite the unpleasantness associated with colonoscopy preparation—bloating, cramping and countless runs to the bathroom—the procedure itself is quick, easy, efficient. And life-saving, according to Dr. Steve K. Georgopoulos, the director of gastrointestinal endoscopy at Southampton Hospital.
“No ‘buts’ about it,” the gastroenterologist quipped this week, “everybody should have a colonoscopy.”
March is National Colorectal Cancer Awareness Month, and doctors are trying to get the message out any way they can.
Colorectal cancer is serious. Cancer of the large intestine, or colon, the lower part of the digestive system, and the rectum, the last several inches of the colon, is the second-most-lethal cancer in the United States, behind lung cancer, for men and women combined.
Approximately 144,000 Americans are diagnosed with colon cancer every year, and approximately 51,000 will die from it each year, Dr. Georgopoulos said.
He added that people often don’t realize how deadly this disease is. They also may not realize how preventable it is, and how easy colonoscopies—exams used to detect changes or abnormalities in the colon and rectum—can be.
A large-scale study, the National Polyp Study, reported a 76-percent reduction in the incidence of colon cancer in those who underwent colonoscopies, Dr. Georgopoulos said. The screening tool, he said, helps to prevent cancer by detecting and removing pre-cursor colon polyps before they have a chance to advance to a malignancy.
Despite horror stories about the pre-procedure laxative routine, which is necessary to clear the colon, the test itself only takes 15 to 20 minutes, is done as an outpatient procedure, and is comfortable for patients because of intravenous anaesthesia, Dr. Georgopoulos said. A colonoscope, a long, flexible tube, is inserted into the rectum, and a tiny video camera at the tube’s tip allows the doctor to view the inside of the entire colon. Polyps and other types of abnormal tissue can be removed with the scope.
“It’s the most important two hours in anyone’s life, other than stopping smoking, to prevent cancer,” Dr. Georgopoulos said, referring to the approximately two-hour window hospital arrival to departure for the test.
Colonoscopies are recommended beginning at age 50, as 90 percent of people who get colon cancer are over 50.
Screening at an earlier age is recommended for those in certain “high-risk” categories, such as those with a family history of colon cancer or underlying medical conditions like Crohn’s disease or ulcerative colitis, a type of inflammatory bowel disease. African-American men also are considered at risk and are encouraged to have the procedure done at an earlier age.
Follow-up could be anywhere from three to 10 years, depending on what is found. The general recommendation is one colonoscopy every 10 years if all is clear.
The test is also recommended to anyone experiencing colon cancer symptoms, which include unexplained rectal bleeding, unexplained anemia, a change in bowel habits and unexplained abdominal pain.
In addition to screening, colorectal cancer prevention is also linked to having a lean body mass, exercise, and eating a diet high in fruits and vegetables and low in meats, high-fat foods and excessive alcohol.