The Screening You Shouldn’t Avoid: How a Colonoscopy Could Save Your Life
The 50th Birthday. It’s quite a milestone—one that should be heartily celebrated with friends and family. But that festive feeling can be tinged with just a little apprehension. In the back of our minds, we know: It’s time for that first screening for colorectal cancer.
While preparation for a colonoscopy is still quite a comedown from birthday cake, it doesn’t necessarily have to be the stressful experience you may have heard about from a friend or family member.
“We reassure patients that they’ll have adequate sedation during the procedure and that colonoscopy is the best way for us to get a complete look at the colon and remove polyps before they develop into cancer,” says Robert B. Cucinotta MD, a gastroenterologist at TriHealth Digestive Institute.
A Dangerous Disease
Colorectal cancer is the second leading cause of cancer death in the U.S. When colorectal cancer is detected at an early stage, the five-year survival rate is 90 percent, but that rate goes down drastically if the cancer spreads outside the colon or rectum. Screening gives doctors a chance to find and remove polyps before they become cancer—a process that can take five to 10 years— and to remove small cancers before the situation becomes critical.
“Many polyps and small cancers can be removed easily during the colonoscopy,” says Dr. Cucinotta. “If we don’t catch it early, it can mean surgical resection of the colon followed up with chemotherapy.”
The Scoop on Preparation
In order to detect polyps, doctors need to get a clear view, which means the colon has to be emptied. While that used to mean drinking a large amount of unpleasant liquid in a short time frame the night before the procedure, today the process is far easier.
Now, you can drink about half of the bowel-clearing liquid the night before, and the remaining dose about six hours prior to the colonoscopy. Planning to be home during this time will, of course, ensure you’re as comfortable as possible.
A few days before the procedure, you’ll be asked to start eating a low-fiber diet free of grains, nuts, seeds, dried fruits and raw fruits and vegetables. The day before your colonoscopy, you’ll be restricted to clear liquids, such as broth, black coffee or tea and clear juice. For the exam itself, you may be advised to take the day off work and must have a friend or relative give you a ride home afterward, as you’ll likely still be under the influence of a sedative.
Having a colonoscopy every 10 years is the “gold standard” for colorectal cancer screening, because it offers the most comprehensive examination, and any polyps discovered can be removed right away during the procedure. However, there are other types of screening procedures available.
CT colonoscopy, or virtual colonoscopy, uses X-rays and computer imagery to give doctors a picture of the colon, and is usually done every five years. Another choice is flexible sigmoidoscopy, which allows doctors to check the inner lining of the rectum and the lower colon. There are even highly sensitive home-test kits that can detect unseen blood in the stool. Those require no bowel preparation, but must be done every year.
Last Updated: February 25, 2018