Health

Why You Need a Colonoscopy

| by Toni Brayer MD

 

One of my pet peeves as a Physician is when people talk about screening tests "Preventing Cancer".  Mammograms, pap tests, prostate tests (PSA), X-rays, blood tests, ultrasounds do not prevent cancer.  The best they can do is detect an abnormality early and allow for treatment.  None of those tests prevent a malignancy.  There is one screening test, however, that CAN prevent cancer and that is a Colonoscopy.  This is because of the natural history of colon cancer.

Colon cancer starts with small benign growths called polyps that progress through several stages of cellular change and transform from normal tissue into adenocarcinoma.  This is usually a slow process that takes  years to occur.  Certain genetic factors are at play and not all polyps develop into cancer.  But identifying and removing polyps that are found at a screening colonoscopy prevents colon cancer.

Isn't that amazing?

If there is no family history of colon cancer, it is recommended that a screening colonoscopy begin at age 50.    If there are no polyps seen, the USMSTF guidelines recommend the next colonoscopy is 10 years later.

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If a polyp is identified and removed, the follow-up colonoscopy depends upon the histologic type of polyp.  A small adenomatous polyp is re-screened in 5 years.  A  tubulovillous adenoma  should have a repeat procedure in 3 years. A hyperplastic polyp should be re-screened in 10 years because the risk of developing cancer is very low.  Despite these clear guidelines, many doctors recommend shorter intervals which results in significant expense and unnecessary discomfort and risk for the patient.

Colonoscopy is the only screening test I know of that can prevent cancer.  It is fairly simple, does not need to be done often and  if everyone over the age of 50 had screening,  it has been estimated that between 60-90% of deaths from colon cancer could be prevented (that’s potentially 30,000-45,000 lives saved) .  

If you are over 50 and have not had a colonoscopy...just do it!

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