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Colonoscopy important for early cancer detection

wellcome images via Flickr
Human colon cancer cells.

Colonoscopies easily fall under a category of medical tests that are important to have done, but are not easy to discuss. Colonoscopies have an uncomfortable stigma, despite the fact that most patients report not having a troublesome experience with them.

This week on Take Care, Dr. Rajeev Jain discusses the importance of colonoscopies.  Dr. Jain is a partner at Texas Digestive Disease Consultants, chief of gastroenterology at Texas Health Dallas and clinical assistant professor of medicine at University of Texas Southwestern Medical School.

Click 'Read More' to hear our interview with Dr. Jain.

Colonoscopies are “a routine screening procedure [of the colon] to detect polyps, which if left alone can transform into cancer, or to detect early cancer and to cure it before it’s had a chance to get out of control and spread to other parts of the body,” says Dr. Jain.

The process of getting a colonoscopy is actually quite simple. Upon arriving, patients are given a mild anesthesia to ensure comfort. A lighted tube, around the width of a finger, is then inserted into the colon and advanced through to look for any abnormalities. This process often takes around 30 minutes.

The abnormalities come in the form of polyps.  “A little bump in the lining of the colon. It can be like a wart on your skin,” says Dr. Jain.

These polyps take one of two forms:

  1. Benign: Usually do not increase one’s risk of colon cancer.
  2. Pre-cancerous: If left alone, these can potentially transform into colon cancer.

The tube used for colonoscopies has capabilities to remove most polyps on site, which is then sent to a pathologist for examination.
But while the procedure itself may be simple, it is the preparation process for colonoscopies that often gets the most criticism. This involves a bowel cleanse to ensure that the colon is clean enough for inspection.

“We have numerous studies that show a direct correlation between how clean the colon is and the ability of the gastroenterologist to find more polyps. So the cleaner the patient is, the more polyps we can remove, and the idea would be that the lower the risk of developing colon cancer then,” says Dr. Jain.

While methods can vary, most preparations involve a split dose preparation. This means the patient drinks a round of the cleansing solution the night before and the morning of the procedure, in addition to not eating or drinking anything to ensure the stomach is clear. This kind of prep is often lower volume and better tolerated than prior preparation methods.

Of course, different people will have different reactions to the cleansing solution, and Dr. Jain believes that because the topic is so sensitive, people are not as willing to talk about their positive colonoscopy experiences.

“I will one-on-one reassure the patient that the vast majority of patients have no problems or minor inconveniences at most with doing the bowel preparation. The most important thing is everything we do has a risk or reward. If we want to decrease our risk of getting colon cancer, this is a small inconvenience to pay to prevent that kind of outcome,” says Dr. Jain.

According to Dr. Jain, people with minimal risk for colon cancer (usually if no immediate relative has been diagnosed with it) should start getting colonoscopies at age 50, and then continue to get them once every ten years.

Those who have a higher risk should consult their doctors on when and how often they should get the procedure done.

A higher number of Americans getting routine colonoscopies have yielded a 30 percent reduction in colon cancer deaths in recent years.