WHAT IS A COLONOSCOPY? THE SIMPLE EXPLANATION

[Ravi Mani]

What is a screening exam?

Medical screening exams are commonly performed on healthy individuals
to look for potential problems before they become serious. A common
example is the Pap smear which is now a well accepted screening tool.
If a Pap smear shows pre-cancerous cells, they can be destroyed and
cancer is prevented. This simple procedure has reduced a woman's risk
of cervical cancer significantly. The basic principle of screening is
that it is much more rewarding to prevent a cancer than find one, even
in early curable stages.

The same rule holds true for colon cancer. Most people don't realize
that colon cancer has become the second leading cause of cancer deaths
in this country, second only to lung cancer. In fact, in non-smokers,
colon cancer is the number one cancer killer with over 56,000
Americans dying this year alone. That's the bad news. The good news is
that colon cancer is also one of the most preventable. This is because
the majority of colon cancers begin as small non-cancerous growths
called polyps. Over time, polyps grow silently and eventually can turn
to cancer. This transformation may take as long as ten years during
which time you feel perfectly fine, unaware of the danger that awaits
you.
How can I tell if I have polyps?

You can't. That is the problem. There are no symptoms of colon polyps
and really no early warning symptoms of colon cancer. By the time a
colon polyp turns into colon cancer and that cancer causes rectal
bleeding or change in bowel habit, it has often already spread to the
liver and other organs. This is why over 60% of cases are incurable at
the time of diagnosis.
How can I reduce my risk of colon cancer?

The best way to avoid becoming a statistic is by beginning a program
of regular screening exams. The most accurate screening test is a
colonoscopy. This painless outpatient "scope" test is done under
"twilight sleep" anesthesia and takes about 30 minutes. Most patients
are pleasantly surprised by how simple it really is. The biggest
complaint is the laxative preparation the night before, although there
are easier alternative available now. But, if a polyp is detected
during a screening colonoscopy, it can usually be removed at the same
time, preventing a future colon cancer.
What other options are available?

There are other options available. All of them have the disadvantage
of limited accuracy. An annual stool Hemoccult test for hidden blood
is often done. This has some significance if abnormal, but the
Hemoccult stool test can miss up to 85% of colon polyps and 60% of
colon cancers.

For this reason, it is often combined with a flexible sigmoidoscopy
"short scope" test. This exam does a good job of visualizing the left
side of the colon and rectum, but cannot examine the right side of the
colon where over 40% of colon cancers develop. Another option is a
barium enema x-ray of the colon, but again the accuracy is limited.
Less than half of significant colon polyps are detected. Colonoscopy
has the advantage of seeing the entire colon directly, making it the
most accurate screening method. For this reason, American Cancer
Society recommendations now include colonoscopy as a screening
procedure.
Who should be screened?

Colon cancer is an equal opportunity disease. It affects all races and
men and women about equally. Current guidelines suggest screening for
all average-risk adults over the age of 50. If the exam is normal and
there are no other risk factors, a re-exam at 10 year intervals is
recommended. Medicare recipients over age 50 are eligible for a
screening colonscopy every ten years if they have not had a
colonoscopy within the past 10 years or a flexible sigmoidoscopy
within the past 4 years. High risk individuals are screened more
often. These would be those with symptoms, prior colon cancer or
polyps, inflammatory bowel disease, prior breast or uterine cancer,
and those with a family history of colon cancer or polyps.
Will my insurance cover this?

As of 2001, Medicare pays for a screening colonoscopy in patients 65
years and older. If you're younger than 65, most insurance plans cover
colon cancer screening, check with your insurer.
How can I schedule a Screening Colonoscopy?

If you are a healthy adult over age 50 and have not had a full
colonoscopy within 10 years or a flexible sigmoidoscopy within the
past 4 years, a screening exam may be indicated. You should first
discuss this with your family physician. If you wish to be contacted
about an appointment, simply contact our office by phone 281-480-6264
or via our website - www.gibay.com.
The Simple Fact…

is that 1 in 17 Americans now develops colon cancer in their lifetime
and the majority is in advanced stages when first diagnosed. This is
especially sad because there is about a 10 year "grace period" before
cancer cells develop and we have the technology to intercede; however,
most individuals do not take advantage of it. We hear the same excuses
every month from the many patients we diagnose with colon cancer. They
were misinformed, embarrassed, too busy, or just afraid to call and
schedule a screening exam; however, once they find out how easily they
could have avoided colon cancer, there are many regrets. Don't be one
of those individuals.

Visit http://www.gibay.com for more information.