Everyone has reasons for not getting a colonoscopy, and Carol A. Burke, MD, of Cleveland Clinic’s Digestive Disease Institute, has heard them all.
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But nothing changes the fact that colon cancer is one of the most preventable cancers. Below, Dr. Burke addresses common concerns about colonoscopy, based on 15 years as a gastroenterologist.
“I’m not at risk for colon cancer.”
The truth is: Everyone is at risk. One in 18 American men and women will get colon cancer in their lifetime. (See below for additional risk factors.)
“I don’t have any symptoms.”
In nearly all cases, colon cancer starts as a precancerous growth in the colon called an adenomatous polyp, which usually doesn’t cause symptoms. A colonoscopy detects polyps so they can be removed before they turn into cancer and cause symptoms. On average, 15 percent of women and 25 percent of men age 50 or over will have precancerous polyps detected by colonoscopy.
“I can’t drink that prep stuff.”
Drinking a bowel preparation is one of the leading deterrents to having a colonoscopy. The good news: Today’s bowel prep is easier than before. Rather than having to choke down a gallon of solution, patients can choose half-gallon options. What’s more, many physicians prescribe a split dose, where half the prep is taken the night before and the other half on the morning of the procedure.
“A colonoscopy isn’t accurate.”
A recent Canadian study reporting that colonoscopies may not completely protect against getting colon cancer received a lot of media attention. But in that study, many colonoscopies were not complete and were performed by general internists and family physicians who may not have had the experience to do the colonoscopy well. Improve your odds of having a high quality colonoscopy by making sure your physician has specialized training in performing colonoscopies and tracks his or her outcomes as part of performance improvement.
“A colonoscopy is too painful.”
Actually, 99 percent of patients should be able to be adequately sedated through conscious sedation or twilight sleep to be comfortable during their colonoscopy. Most patients don’t even remember the exam! Cleveland Clinic also offers monitored anesthesia care for patients who require deeper sedation.
“It’s too risky.”
When performed by specially trained professionals, colonoscopies are safe. For example, the risk of perforation is less than 1 in 1,000 cases, and the risk of bleeding is less than 1 percent.
“If I get colorectal cancer, then it was meant to be.”
Not true. Colon cancer is preventable. Here’s how: Begin screening for colon cancer (colonoscopy is the preferred screening strategy) at age 50, or earlier if you have risk factors. Change your lifestyle now: improve your diet, maintain a normal body weight, exercise and avoid smoking.