March Is Colon Cancer Awareness Month

Precancerous polyps don’t usually produce noticeable symptoms so if you are experiencing any changes in bowel habits, including diarrhea, constipation or a change in stool, rectal bleeding or blood in your stool, persistent abdominal discomfort (cramps, gas, pain or feeling full/bloated), unexplained weight loss, nausea or vomiting or chronic fatigue it is best to discuss these changes with a Gastroenterologist and get a colonoscopy scheduled.

A colonoscopy is an examination of the inside lining of the colon, which is where colon cancer starts. During a colonoscopy, a long, narrow, flexible tube with an HD camera at the end is used to evaluate the rectum and colon.

Colonoscopies can detect conditions like colitis, inflammatory bowel disease and diverticulosis. But mainly, doctors are looking for precancerous or cancerous colon polyps, which are growths on the inside of the colon’s lining. If the doctors spot polyps, they can quickly and painlessly remove them during the same colonoscopy.

A colonoscopy is not painful. Patients are completely sedated to ensure maximal comfort.  Following your procedure you can eat whenever you are comfortable doing so and return to your normal activities the next day.

The entire procedure should take between 20 and 30 minutes. You’ll stay in a recovery room for about 30 minutes to an hour to wake up from the sedative.

A clear liquid diet is necessary starting the day prior to your colonoscopy. You will also need to drink 2 – 16 oz serving of prep prior to your procedure. One the night before and one the morning of your colonoscopy to cleanse your colon.

Cologuard and colonoscopy are not the same.  Cologuard is a stool DNA test that detects cancerous cells in the colon. A colonoscopy is a preventative procedure that allows a physician to see and remove precancerous polyps from the colon and detect changes.

The American Cancer Society is recommending the average risk patient to begin colorectal screenings at age 45. This guideline has recently dropped from age 50, however only a few insurance companies have adjusted their policies to reflect the new recommendations. Please check with your insurance company to understand your benefits.

It is best for you to beginning regular screening colonoscopies at age 32, 10 years prior to your mother’s diagnosis.

Colon cancer does not discriminate and affects men and women equally.

The American Cancer Society recommends that people at average risk of colorectal cancer (none of risk factors) start regular screening at age 45. Increased or higher risks patients may need to start colorectal cancer screening before age 45 or be screened more often.

Both men and women are equally at risk for colon cancer. The cancer is most common among people aged 50 and older but can occur in patients as young as teenagers. Over 75 percent of colon and rectal cancers happen to people with no known risk factors, which is why regular screening is so important.

There is no expected normal number for polyps on a colonoscopy. But among those physicians who routinely perform screening colonoscopies, the national standard is to detect precancerous polyps a.k.a. adenomas and/or colon cancer in over 25% of all patients. Therefore, we expect to find precancerous colon polyps in at least every 1 out of 4 patients. This can be broken down further to a standard to detect adenomas or colon cancer in more than 30% of male patients and more than 20% of female patients.

All insurers cover screening colonoscopy at age 50. However, recent recommendations from the American Cancer Society some were to begin colon cancer screening at age 45. As a result, many insurers have begun to cover colon cancer screening beginning at age 45.

Yes! As soon as you are awake enough after your procedure, your Gastroenterologist will discuss the results with you. The only information that may come with a few days delay is that regarding any pathology samples taken during your procedure. Once these have been reviewed under the microscope, you will get these results as well.

Short answer, yes. Colonoscopy is a Tier 1 form of colon cancer screening and is the gold standard. CT Colonography is a Tier 2 form of colon cancer screening.  Generally, CT Colonography is best reserved for patients with known history of very difficult and/or incomplete prior colonoscopies. It may also be considered for those willing to undergo bowel preparation but have significant concerns about potential risks with colonoscopy and/or anesthesia.

A colonoscopy is the only test to both detect and prevent colon cancer by removing precancerous polyps.
Cologuard can miss up to 8% of colon cancers and more than 50% of pre-cancerous polyps.
FIT misses 20% of colon cancers and can miss most pre-cancerous polyps.