Shudder at the thought of a colonoscopy?
You shouldn’t, according to University of Minnesota Health Gastroenterologists Stuart Amateau, MD, PhD, and Byron Vaughn, MD.
Most people only feel minor discomfort, if any, during the screening, which allows doctors to examine the inside of the colon for signs of potential colon or rectal cancer. Specialists are able to remove potentially cancerous polyps during the procedure, which means a colonoscopy is also the only cancer screening that combines detection and primary prevention.
March is National Colorectal Cancer Awareness Month, and in honor of the awareness event Amateau and Vaughn offered five helpful facts and tips about colon cancer screening:
Most people should begin colon cancer screening at age 50, and repeat the process every 10 years.
This standard holds true for people with no family history of colon cancer or other risk factors. If one or more of your first-degree relatives—including your father, mother or siblings—have been diagnosed with colon cancer, you may need to begin screening at an earlier age and consider shorter intervals between screenings, Amateau and Vaughn said.
You may also need more frequent screenings if doctors conducting the colonoscopy find benign colon polyps during the exam. Roughly 30 percent of colonoscopy patients have polyps, which can eventually develop into cancer if left untreated. Depending on the number and size of the polyps found, doctors may request that you schedule more frequent colonoscopies.
People who have a history of inflammatory bowel disease (IBD), including ulcerative colitis or Crohn’s disease may also need heightened surveillance because they are at a greater risk for colon cancer. Special techniques such as chromoendoscopy, which are offered through University of Minnesota Health, may help doctors find pre-cancerous lesions in people with IBD.
For the vast majority of patients, the procedure is not painful.
Some people are anxious about colonoscopies, but very few patients actually experience any discomfort during the procedure, Amateau and Vaughn said. Nurses work with patients before the procedure to answer questions and address concerns so that the procedure is less worrisome. Most patients receive moderate sedation for the procedure. Moderate sedation may not be adequate for a selection of patients. Deep sedation is typically available for those who need it. We also offer un-sedated exams. Your University of Minnesota Health care team will work with you to identify your needs.
“The team that’s taking care of the patient really wants to make sure they have a comfortable exam,” Amateau said. “By nature, comfortable exams are more accurate and safer.”
Water exchange colonoscopies are another innovative approach that lessens discomfort and reduces the need for sedatives.
Preparation for a colonoscopy is critical.
Emptying the contents of your colon is important for a successful, accurate colonoscopy. The doctor’s exam is only as good as the bowel preparation, Vaughn said. Although the laxative portion of the prep generally starts one day before the exam, it is important to review the bowel prep instructions at least one week prior to your test to make the recommended diet changes, which include switching to a low-fiber diet that excludes whole grains, nuts and dried fruit several days before the screening.
The day before the colonoscopy, patients are asked to refrain from consuming solid foods. Patients must also consume a bowel prep, which will help clear the bowel. Amateau recommends consuming half the prep the day before the procedure and half the day of the procedure. Exact instructions may change based on the preferences of your doctor.
A colonoscopy is one of the few screening methods that offers both detection and prevention.
If doctors find any polyps during the exam, they will remove them during the colonoscopy. For that reason, colonoscopies are the only cancer screening method that currently offers both detection and direct prevention.
“Other methods of screening are focused on preventing death from cancer, not preventing development of cancer,” Vaughn said. “For this reason, the colonoscopy is a highly effective method of preventive care. If another screening test is positive, generally the next step is a colonoscopy.”
There are other screening methods besides a colonoscopy.
A traditional colonoscopy is the standard for colon cancer screening methods because offers a thorough examination of the whole colon, but other methods exist. These alternatives include the flexible sigmoidoscopy, which only evaluates the rectum and the lower third of the colon. Patients using this method should receive a sigmoidoscopy every five years, Amateau and Vaughn said.
Patients can also choose hemoccult testing, which detects blood in stool samples (one sign of colon cancer). To be effective, the hemoccult testing must be repeated every year, both doctors added.