By Baret Bercier, M.D.
USA Health Digestive Health Center
The gold standard of screening for colon cancer is the colonoscopy, a low-risk, minimally invasive procedure that helps detect precancerous polyps and removes them before they develop into anything worse.
Today, compared with 10 or 20 years ago, the colonoscopy experience is easier for patients. The day before consists of a slightly restricted diet and a bowel prep to clean out the colon before the procedure.
If you have a friend or family member who has had a colonoscopy in years past who has told you horrible stories, the preps are easier now than they ever have been. In general, we use a low-volume, split-dose preparation consisting of a small bottle of medicine followed by quite a bit of water.
Another dose will be taken five hours before the procedure so that the colon is clean. There’s also a pill-based form of the prep, which is 12 pills twice with a lot of water.
If you don’t want to start with a colonoscopy, stool-based tests such as Cologuard or FIT Test are available if you are at average risk, which means you have no family history of colon cancer. However, if you test positive, the next step is still a colonoscopy.
On the day of the procedure, the patient will come to the GI lab at the hospital, where they’ll get an IV placed and be given anesthesia so they are asleep and in no pain throughout the entirety of the screening.
The medicine wears off quickly, and patients are typically up, talking and feeling relatively normal 30 minutes to an hour after the colonoscopy is complete. By using CO2 to inflate the colon instead of air, recovery is faster. The CO2 dissolves on its own, which eliminates the cramping and bloating that patients used to experience afterward.
Still, it’s recommended to take off work the day of the procedure and have someone drive you home after it’s done. There are no dietary restrictions after the colonoscopy is complete, so get your favorite food, and rest.
Frequency of screenings vary from patient to patient. For an average-risk individual, a patient with no family history of colon cancer and no symptoms, we recommend starting screening at age 45. If no polyps are found on the colonoscopy, the patient will need another one in 10 years. If they do a stool-based test such as Cologuard, it will need to be repeated one to two to three years max.
Family history puts a patient at elevated risk, so if you do have a family member with a history of colon cancer, you are not a candidate for a stool-based colon cancer test. In that case, a colonoscopy is recommended.
It’s possible that you may have to be screened at an earlier age depending on the age at which your family member was diagnosed. This would apply to your first-degree relatives: mom, dad, brother, sister or child.
If you haven’t had a colon cancer screening yet, you do have options.
Learn about your family history, and talk with your physician to
develop your preventive care plan.
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