Should I Get a Colonoscopy?

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by Richard Saltus

Colonoscopy exams get a bad rap.

Even though the exam is brief and painless, many people fear and avoid them. Roughly 40 percent of Americans for whom they are recommended are not getting colonoscopies.

Yet colonoscopy is one of the most effective of all cancer prevention methods. The American Cancer Society estimates there will be 142,820 diagnoses of colorectal cancer in 2013 and 50,830 people will die of the disease.  As many as 60 percent of colon cancer deaths could be prevented if everyone 50 years old or above underwent colonoscopies, according to the Centers for Disease Control and Prevention (CDC).

Charles Fuchs, MD, MPH

Charles Fuchs, MD, MPH

“Screening with colonoscopy is a huge opportunity to prevent this disease,” says Charles Fuchs, MD, MPH, director of the Gastrointestinal Oncology Center at Dana-Farber. “Deaths from colorectal cancer have been going down over the past 10 years, and probably 50 percent of that reduction is due to screening.”

Guidelines say that at age 50, everyone should consider having a screening test for colon cancer. (About 90 percent of new cases and 95 percent of colon cancer deaths occur after age 50.) Screening are a test for blood in the stool, repeated annually; an exam with a thin, flexible tube called a sigmoidoscope every five years; or a colonoscopy every 10 years.  “If you have a first- degree relative with colon cancer, exams should start between ages 35 and 40,” says Fuchs.

Colonoscopy is the most reliable test, because doctors can visually study the entire colon and rectum, Fuchs says. In addition, a colonoscopy not only can detect cancers in their earliest and most treatable stages; it can also detect pre-cancerous polyps and that can be removed during the exam before they become cancerous.

“People have a misconception of the test – it’s not really that arduous,” says Fuchs. “When you talk to someone who has had precancerous lesions or early cancer because of a colonoscopy, they tell you how glad they are they had the test.”

If the exam is normal, a colonoscopy should be repeated every 10 years up to the age of 75. If the test detects precancerous polyps, the physician will recommend that colonoscopies be repeated more frequently.

 

17 Comments:

  1. Hi, i am only 26 years old however over the past couple years have had hemorrhoids/pain in the colon area. Sometimes even hard to have a bowel movement. I do believe that ive had uncles on my mothers side or.it may have actually been my dad most recently to have had colon cancer. He was in his early 50s. Is this something that i should get checked out or to maybe have an early colonoscopy? Thanks for your time.

  2. Hello, Darren.
    Thanks for your comment. Yes, we’d suggest that you discuss your symptoms with your doctor.
    Best wishes.

  3. Nice Blog thanks to share this all information here…

  4. Doctor, can you recommend how long I should wait to have a colonoscopy after my last flare up of diverticulitis?

  5. Ann Marie Gartland

    I was diagnosed with colon cancer at age 37. There was mo family hisyory of colon cancer. Had I not had a colonoscopy I may not be here today. All of my siblings had to be screened also. Thankfully they were all fine. The test is painless and you a usually asleep for the entire process. I highly recommend this screening.

  6. Georgia Patterson

    I had planned to address this myself, since I feel so strongly about wanting to share the TRUTH about the exam, since there is so much misconception! Dr. Fuchs beat me to it: “COLONOSCOPY EXAMS GET A BAD RAP!” They really do! The prep is no worse than a very few hours of a diarrhea, which we have all had. The exam itself is conducted in a comfortable position, with light sedation, and there is No Pain or Discomfort! I have had two. My husband had no symptoms of colorectal disease, and yet when he became ill he was found to have greatly metastasized colon cancer, and only lived twelve days after his diagnosis. He was only 50, and would have had the recommended exam, but the disease made itself known before he was able to. SCHEDULE THIS TEST WHICH IS ALSO PREVENTATIVE, IN THAT THE PHYSICIAN IS ABLE TO DEAL WITH ANY SYMPTOMS ACTUALLY DURING THE EXAM! ~ The day before my first mammography, 26 years ago at age 40, there was a column, written by a woman, in The Boston Globe. It highlighted the horrible machine, the pain, insult, indignity, and how a “man” designed the machine! I kept my appointment the next day, but I admit to having had the fleeting thought of canceling it. To this very day, I think of woman who perhaps did cancel their mammogram, and what their outcome may have been. And I think of the author of that column who should have approached it in a very different way, explaining and yet ENCOURAGING life saving testing.

    • Dear Georgia –
      We are so sorry for the loss of your husband. Thank you so much for connecting with us and sharing your experience. Wishing you all the best.

  7. I had a colonoscopy at 50 and they found a very tiny tubular adenoma and because of that I have to go every five years for my colonoscopy. Had I pushed it off who knows what would’ve happened. I was so afraid of the prep. Where I live they let you have a light breakfast the morning before and then it’s clear liquids. The prep was one bottle of MiraLAX mixed in with Gatorade and I had no problems. It wasn’t harsh or anything. When I got to the colonoscopy unit they were so nice and when I was wheeled into the room I was given medicine and all I remember is waking up and it was done. It was easy.

    • Dear Jane –
      Thank you for connecting with us and sharing your experience with other readers. Wishing you all the best.

  8. Amy Rader-Sabina

    A colonoscopy saved my life in 2008. They found an ”area of interest”. Turned out to be squamous cell carcinoma of the anus. My 2nd opinion was @ Dana Farber. I am now about to be 7 years free of cancer. Thank you! I now live a normal and grateful life!

  9. Dr Fuchs took care of my husband for 4 years. One of the most human and caring doctors I have ever met.

    • Dear Christina –
      Thank you so much for your kind words and for sharing your experience with us. Wishing you all the best.

  10. I was diagnosed at age 44 – accidentally through a chest x-ray when it was thought I could have pneumonia. My colon cancer had already metastasized (spread) to my lung. No family history. No symptoms. Don’t have time? Think the test will be uncomfortable? Well, the test and prep are not as bad as you probably imagine. And guess what? Caught early, colon cancer can be defeated. Mine was stage 4. Am I frightening you? I hope so – because I don’t want anyone else to go through this! And if you don’t think you have time now….. you WILL regret it later when everyday you spend a good deal of your time combating the disease…. I care, that’s why I want to bring awareness and avoid needless suffering. So please get your colonoscopy if you age 40 or older! My siblings have all been tested. A couple had polps removed during the test. They are fine! I was diagnosed in 2009. And here I am just about 6 years later and living life! Thank you Dana-Farber and Dr. Enzinger! I love the Dana-Farber commercial – “What cancer does not know is you have us.” It is true! :)

    • Dear Meredith –
      Thank you so much for connecting with us and sharing your insight. It’s wonderful to hear you are doing well. Wishing you all the best!

  11. I just had my third colonoscopy. My first and third we performed by the Veteran’s Administration in Jamaica Plain (Boston) and the second at Brigham and Women’s. A one day prep just didn’t seem to work for me…using GoLitely, yuk!. A two day prep with MoviePrep did the trick. I prefer the MoviePrep big time! Never slept through any of the colonoscopies…remained wide awake through all three. Had an adinoma removed (pre-cancerous) this last one so really glad the two-day prep worked. No complications. Although I’m not involved with Dana Farber–thank you for allowing everyone post here. I’m 59 and had my first colonoscopy at 52 second at 58 and last one in March, last month.

    Those of you reading this don’t put it off if you are over 50 and/or have a first-degree family history. My sister-in-law (not genetically related) was 70 when she was diagnosed with Stage 4 colon cancer and we lost her shortly afterward. Just sayin’.

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