How is a colonoscopy like filling out your income tax forms?

By: Judith K. Volkar, M.D. • Posted on February 23, 2012

How is a colonoscopy like filling out your income tax forms?

To me, a colonoscopy is a bit like doing my income’s uncomfortable, messy, but very necessary. A study released today reiterates why it is necessary. In patients tracked for twenty years, the death rate from colorectal cancer was cut 53 percent in those who had a colonoscopy and had precancerous polyps removed. A reduction in deaths from cancer of that magnitude is huge.

Colon cancer is the third leading cause of cancer-related deaths in the United States. In women, only breast and lung cancer are more lethal. Colon cancer is expected to kill more than 25,000 women in 2012. Like almost any cancer, colon cancer, if it is caught early, has a ninety percent survival rate. And the beauty of a colonoscopy is that it can catch colon cancer even sooner than an early stage. Precancerous polyps can be removed during the colonoscopy, which is what causes the reduction in mortality.

So we have a test that causes a huge reduction in mortality from a fairly common cancer. We are all getting this, right? Wrong! The percent of people who get this recommended screening test is a sad, miniscule 24 percent.

There is a slight risk of bleeding or making a hole in the bowel when performing a colonoscopy. But the biggest reason why patients don’t get a colonoscopy is because they are afraid of the preparation that happens before the procedure. A colonoscopy involves placing a fiber optic light inside the colon to view the bowel wall. The patient needs to clean out the bowel of all its contents so there is a clear view.

But the preparation should really not be feared. There are preparations out there that do not involve ingesting gallons of pineapple flavored salt water. Most bowel preps are started around five o'clock the evening before the procedure and are really not that bad. Rent a movie for a portable DVD player or buy a good book and just whole up in the bathroom for a few hours. During the actual procedure you can be given sedation so you do not remember a thing. Alternatively, if you really want to know yourself inside and out, most physicians will let you view the procedure on a video monitor. If a polyp is found, it can be removed at the same time and a repeat colonoscopy will be done in about three to five years. And if nothing is found, you are good for ten more years!

There are so many things in our life and health that we cannot control. We can’t choose our genetic susceptibility to a medical issue, but we can choose to do everything in our power to diagnose a problem early while it is a small problem rather than a big one. So in honor of income tax season, go get your colonoscopy!

- Judith K. Volkar, M.D.

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