By Sue Smith
Q: I am turning 45, and my doctor says it’s time to get my first screening colonoscopy. Can you tell me more about this and what I can expect?
A: Screening colonoscopy is a procedure used to look for colon cancer or precancerous growths in people who have no symptoms of the disease. Since colon cancer usually takes years to develop and almost always starts in growths called polyps, colonoscopy is a way to look for these growths and remove them before they turn into cancer. In addition to colonoscopy, there are a variety of other tools used to screen for colon cancer, and you can check with your doctor to see if these are appropriate for you.
The American Cancer Society has recently lowered the recommended starting age for screening colonoscopy from 50 to 45 for most people. Those at average risk for developing colon cancer based on medical and family history are screened every 10 years as long as no abnormalities are found. The frequency of screening increases with increased risk for colon cancer. It is generally recommended that screening continue until age 75, after which the decision is based on individual factors like medical history, expected lifespan, and prior screening results.
Preparation for a screening colonoscopy begins with a modified diet starting a few days before the procedure. This may include temporarily stopping some medications and supplements — your health care provider will provide detailed instructions to follow. The evening before the procedure, a laxative preparation is taken to ensure that the colon is completely emptied. For many people, this is the most disagreeable part of a colonoscopy, but it is a critical step that allows your doctor to view the inside of the colon.
The day of the colonoscopy, you will be given an intravenous sedative to make you comfortable during the procedure. A long, flexible tube with a light and camera is inserted into the rectum and all the way into the colon where your doctor (typically a gastroenterologist) can carefully examine the inside of your colon and sample (biopsy) any suspicious areas if present. The procedure is done in an outpatient setting and is usually completed in under an hour. You may feel groggy afterward and will be required to have someone drive you home.
Complications of the procedure are few, but nausea, vomiting, bloating and rectal irritation may occur from the laxative preparation. Bleeding can be a complication of any biopsy or polyp removal. A rare but serious complication is perforation (a hole) in the colon wall.
Medicare and most health insurance plans will pay for screening colonoscopy, which is considered to be an important and effective preventative health care measure.
Sue Smith volunteers with the Grillo Center, which offers free, confidential research to assist in health understanding and decisions. To use this service, contact grillocenter.org or 720-854-7293. No research or assistance should be interpreted as medical advice. We encourage informed consultation with a health practitioner.
Where to find it
National Institute of Diabetes and Digestive and Kidney Diseases
Google: colonoscopy niddk
Centers for Disease Control and Prevention
Google: cdc colorectal cancer screening
Google: colon cancer screening mayo clinic
American College of Gastroenterology
Google: acg colonoscopy