If you're 45 or older, it's time to talk with your doctor about scheduling a colonoscopy. In fact, if you have a family history of colorectal cancer or other risk factors, your primary care provider might recommend that you start earlier.
Why? Early diagnosis can change the outcome dramatically.
Excluding skin cancers, colorectal cancer is the third most diagnosed cancer in the U.S. Colorectal cancer is expected to cause 53,000 deaths this year, according to the American Cancer Society, and colorectal cancer is expected to be the leading cause of cancer death for people between the ages of 20 and 49 by the year 2030, according to the American Society of Colon & Rectal Surgeons.
Yet experts estimate that 60% of those deaths could be prevented through screening tests that can lead to early detection.
While there are several screening options available, it is important to choose the one that is right for you. Your primary care provider can help you decide, based on your risk factors, family history and other factors.
Colonoscopy is the most commonly offered screening for colorectal cancer, and it is considered the gold standard. During a colonoscopy, a doctor uses a thin, flexible, lighted tube to check for polyps or cancer inside the rectum and colon. Most polyps and some cancers can be found and removed during this test.
Common fears and misconceptions surround colonoscopies, and until relatively recent years, colon cancer screening might not have been openly discussed. Overcoming those fears and scheduling that appointment could be a lifesaver - literally.
Colonoscopy prep is a necessary part of the process
Fear and discomfort about the process of colonoscopy preparation is no small issue, said Dr. Davis Brian Berry, a gastroenterologist with AnMed Gastroenterology. Preparing for the procedure includes taking medication to empty the colon. Dr. Berry said that he and AnMed gastroenterologist Dr. Rabin Neupane have worked to make their prep system simpler for patients, by combining medication with Gatorade for a process that is gentler than patients might expect.
"I try to talk to people about their prep," Dr. Berry said. "A lot of people will just chug the prep, and it's a lot better if you just sip it slowly."
While it likely means an afternoon at home the day before the procedure - Dr. Berry encourages some TV time while sipping the prep - patients should ask questions if they have concerns about what the process will be like. It's OK to ask, especially if those unknowns could be holding you back from scheduling the screening.
"There are options available," Dr. Neupane said.
Following the colonoscopy, patients can generally have a normal meal, Dr. Berry said. Some even stop for takeout on the way home.
Another common hurdle for patients is fear about anesthesia. Dr. Berry said the type of anesthesia now used for a colonoscopy is considered moderate, and it is different from the general anesthesia that someone would have for surgery.
In fact, patients are awake quickly once the procedure is complete. Risks are reduced without sacrificing comfort. It all makes for a good nap, according to Dr. Berry.
Colonoscopy is a tool for both screening and treatment, and it doesn't hurt like it used to for some
Colonoscopy is both a screening tool and a form of treatment, since polyps found in the colon are commonly removed during the procedure. Dr. Berry said patients will find that colonoscopies done according to the modern standard of care generally are comfortable. In the past, patients might have experienced abdominal cramping, often due to the use of regular air to inflate the colon, but that has been replaced with carbon dioxide, which results in a significant improvement in comfort.
The amount of time needed for a colonoscopy varies by patient, but Dr. Neupane said the average is 20 to 30 minutes, with about an hour and a half from check-in to wake-up after the procedure.
Despite knowing that early detection saves lives, it is human nature to want to delay. Dr. Neupane said you can't deal with a problem if you don't know that it exists.
"It's better to know that you have a problem or don't have a problem rather than just ignoring it," he said. "Knowing it earlier is safer and easier in the long run."
Dr. Berry said it is important to talk through that concern and know how critical it is to get tested so early treatment, if needed, is an option.
"Just do it for your family and for your kids, so you can keep taking care of your family and be there for them," Dr. Berry said. "It's for you, but it's for your family, too. Cancer affects everybody in the family."
How to plan a colonoscopy and get it done
Dr. Berry wants patients to know that it's OK to ask questions and have their concerns and fears addressed. Ultimately, getting screened is critically important.
"I think they'll find that it's much easier than they think, and it's much more comfortable," he said. "And for your family, it's good information to have. I've seen it make a big difference in families. You're preventing cancers - particularly when I find a large polyp and I can remove it. A large polyp can turn into cancer very quickly. Most colon cancers are asymptomatic. Just because you're feeling OK doesn't mean you don't have colon cancer."
To schedule a colonoscopy or another colon cancer screening procedure, visit anmed.org/services/gastroenterology/colorectal-cancer-screenings or contact your primary care provider.