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Click on the article link below for background information to this blog post:
“Colonoscopy examines the colon via a flexible scope that
transmits the images to a video screen while the patient is sedated. The claim
that it is the best screening option has been based on assumptions and
expectations about what it can do—allow a doctor to examine the entire colon
and rectum and remove polyps during the procedure. But colonoscopy’s
superiority has never been proven in randomized controlled trials (the “gold
standard”) comparing its effectiveness to other tests. Other kinds of studies
have suggested that colonoscopy (typically done every 10 years if no cancer or
polyps are found) doesn’t save more lives than sigmoidoscopy, which examines
only the lower part of the colon and is usually done every five years. In some
studies, sigmoidoscopy was combined with stool tests. Two large randomized
controlled studies comparing colonoscopy with stool tests are underway, but
results won’t be available for years…
One problem with colonoscopy is that it’s less effective in
detecting polyps and cancer in the right side of the colon (the upper portion,
including the ascending colon and cecum) than the left side. This is because
many polyps and cancers in the right side are flat, pale and difficult to
identify and remove completely. Also, bowel cleansing may be less complete in
the right side of the colon, making detection more difficult there.
Other factors can also reduce colonoscopy’s accuracy. For
instance, it tends to be less accurate when done comparatively quickly, by less
experienced doctors (typically those who are not gastroenterologists) and/or
when patients don’t prep adequately to empty the colon.
In addition, though colorectal cancer starts in certain adenomas
and other polyps, the vast majority of polyps detected and removed (including
most ademonas) are harmless. It’s estimated that 30 to 50 percent of Americans
over 50 have or will develop adenomas, and that between one and 10 percent of
these polyps will progress to cancer in five to 10 years.
Finally, colonoscopy poses a small—but not insignificant—risk of
serious complications such as bleeding or colon perforation.
Sigmoidoscopy has some advantages over colonoscopy. It costs
only a fraction as much, is quicker and can be done well by primary care
doctors. The prep is simpler, and sedation is usually not needed. But it too
misses some cancers, especially since it can’t examine the upper portion of the
colon. And if suspicious polyps are found, you’ll need a colonoscopy to remove
them and check the upper colon…
A 2010 review paper in Gastroenterology concluded that
annual highly sensitive FOBT [take home stool test kits] is indeed effective at
identifying colon cancer and reducing deaths from it. Because it is
inexpensive, more people can afford FOBT, so it may save more lives than
colonoscopy, according to some analyses. But FOBT is most effective only if
people are compliant—take the test annually and do the follow-up tests when
necessary.”
They share that anyone from
age 50 to 75 years old should be discussing colon health and testing with their doctor in
order to maintain a healthy life.
I’ll be starting the prep
tomorrow and undergoing a colonoscopy procedure Monday afternoon. I must admit I would
love to fast-forward the next 48 hours but I’ll push myself through it and, in
the meanwhile, I figure it is the perfect detox to help cleanse myself of 2014
a bit early and get on track for a healthier 2015!
Let me know if you’ve had a
colonoscopy and, if so, would you consider doing it again when needed after experiencing it the first time?
