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Colonoscopy 101

Lit Happy Birthday candles on cake

Colonoscopies can prevent cancer. It’s that simple.

Yet, only about half of those 50 years or older – the population where the disease is most prevalent – get colonoscopies. As a result, more people are needlessly dying of colon cancer – over 50,000 a year in US alone. The disease is currently the third-leading cause of cancer deaths in both men and women in this country and the third most commonly diagnosed cancer.

Early detection has always been a goal of colonoscopy because colorectal cancers that are caught early are more amenable to surgical cure. In recognition of Colon Cancer Awareness month, we broke down the basics of colonoscopies and why they’re so important.

What is a colonoscopy?

Most colon cancers come from abnormal growths of tissue in the lining of the colon called polyps.

A colonoscopy uses a slender, flexible tube with a light and video camera on the end that allows the doctor to view the entire colon. It not only identifies potentially pre-cancerous polyps but also removes them.

The entire procedure, during which the patient remains under sedation, takes about 30 minutes and is not painful.

Are all polyps the same?

Most people think of polyps that are mushroom shaped but now, thanks to high-definition endoscopes with electronic enhancing imaging, we’re finding flat lesions that may have been missed. These lesions have a more accelerated pathway to cancers.

Who should get a colonoscopy?

The American Cancer Society has recently proposed new recommendations that lower the screening age to 45.  Ask your primary care physician when you should start screening.

If a person’s first colonoscopy is normal, the procedure should be repeated every 10 years, unless risk factors exist.

How should you prepare for a colonoscopy?

Prior to getting a colonoscopy, the entire bowel must be emptied. The prep is probably the most feared aspect of colonoscopy. Indeed, at one time, this required drinking a gallon of a prescribed preparation in a short period of time.

There’s been considerable progress in this arena. Penn Medicine uses a low-volume (half gallon) and splits dose prep. The patient drinks one quart, waits six hours, and then the second.

Providing a prep that people find more tolerable is essential: The quality of the exam is only as good as the quality of the prep.

Is colon cancer treatable?

In its early stage, colon cancer is often highly treatable; however, it’s a silent disease. There are no symptoms until the advanced stage, when survival rates plummet to less than 10 percent. Preventing the disease from starting remains the goal.

Early detection and proper screening by colonoscopy can prevent 90%of colon cancers. I’m glad we’re demystifying colonoscopies. Knowing more saves lives.

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