The Dreaded Colonoscopy

Author: S. Bledsoe, M.D.

Without a doubt, the most hated cancer screening test is the colonoscopy.  People come to their physician for a colonoscopy kicking and screaming.   Most of their fears are totally imagined.  What is not imagined is the benefit that a screening colonoscopy provides.


In February of 2012, The New England Journal of Medicine published a fantastic article proving, yet again, that colonoscopies and the removal of colorectal polyps (precancerous growths) saves lives.  Between 1980 and 1990, 2602 patients had polyps removed during a colonoscopy.  After following them for up to  23 years, they compared the groups mortality due to colon cancer to the expected mortality for society as a whole.  They found that polyp removal reduced colorectal cancer deaths by 53%.


Now that I have your attention, who gets colonoscopies?  The easiest answer is at the age of 50 and then every 10 years, if you have a normal exam.  It is way beyond the scope of this article to give you every possible contingency for every situation.  If you have any bowel symptoms or if colorectal cancer runs in your family, talk to your primary care physician about timing.


With the studies so convincing of the benefit for colonoscopies, why would someone choose to not have one done?  The number one answer is fear.  Fear about what might be found.  Fear about the procedure itself.  Fear about the bowel prep.  It’s true.  The bowel prep is no fun.  While the prep not something to be excited about, it is hardly a reason to not have a colonoscopy.  The procedure itself isn’t bad, because you won’t even remember it.  I personally perform hundreds of colonoscopies a year.  I use an anesthetic (propofol) and an anesthesiologist who monitors the patient.  I have never had someone tell me that they remember any aspect of the procedure, much less been in pain.  I understand why people may be fearful over the prep or the procedure, but fear about what might be found is something I do not understand.  If colon cancer runs in your family or if you are having troubles, sticking your head in the sand will not help.  Pretending like you are not at risk will not make the risk go away.  Be fearful of the cancer- not the screening test.


There are some readers who will follow every recommendation made by their physician.  This post isn’t for you.  There are some who will never get a colonoscopy for one reason or another no matter how beneficial it is to them.  This post isn’t for you either.  I hope, though, that I have motivated a few procrastinators and calmed a few of you “Nervous Nellies” out there.  If everyone got a screening colonoscopy at the proper time, colorectal cancer would be a far less common cause of death.  Don’t be a statistic.  Get your colonoscopy.  Now!

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