By Margie Coloian
Colorectal cancer is the third most common cancer found in men and women in the United States. A substantial number of cancers may be prevented by removing polyps. With colonoscopy, polyps can be found and removed before they turn into cancer. Experts agree that on average, everyone should be screened for colorectal cancer around age 50. High risk individuals (with a family history of colorectal cancer, a history of inflammatory bowel disease or a personal history of precancerous polyps) should be screened at an earlier age.
The American Cancer Society says every year there are about 150,000 new cases of colon and rectal cancers. So why is it that half of those age-eligible have never had a colonoscopy or failed to be retested? Here are some of the reasons patients cite for not being tested, according to Patricia Roberts, MD, chair of Colon and Rectal Surgery at Lahey.
I don’t want to drink the unpleasant prep.
Preps have changed a lot over the years, says Roberts. The volume you need to drink is not the same; it’s less. Roberts recommends drinking the prep through a straw instead of by cup to ease it going down. Also if you feel crampy or nauseous while drinking, take a break, and then start drinking it again. Some may elect to add a little Crystal Light or another flavored powder to the mix.
I’m scared about the procedure.
“This is a very safe procedure,” Roberts says. “The prep may very well be the worst part of it.” Most patients undergo the procedure with intravenous medications, called conscious sedation, which allows them to respond to commands while limiting any discomfort. At some colonoscopy sites, like Lahey, you may elect to have an unsedated colonoscopy.
There is another option, virtual colonoscopy. Roberts says the prep is the same for this procedure as for traditional colonoscopy, but the procedure itself is considered less invasive. Images of the large intestine are taken using computerized tomography (CT). If polyps are found, though, an optical colonoscopy is needed for polyp removal. While the American Cancer Society has endorsed the procedure as an option, the examination is not as sensitive in picking up small polyps and is generally not covered for screening by health insurance.
It’s embarrassing.
“Get over the embarrassment,” Roberts urges. “It’s better to be embarrassed than dead of colon cancer.” This is a very important test. About 10 to15 percent of patients undergoing colonoscopy are found to have polyps, which are removed, many before they are cancerous.
I don’t have a family history.
It doesn’t matter. Less than 20 percent of patients with colorectal cancer have a family history. The vast majority of colorectal cancers are not hereditary, says Roberts. “That’s why we perform colonoscopies in the first place, because we don’t know who will have polyps.”
