Benefits Found for Colonoscopies

Bob Pedersen, a fellow Type 2 blogger first wrote about his experience of having a colonoscopy here (link is broken and site no longer exists). It was humorous and to the point. They put me under as well using an IV and a slow drip. I have had five of these and only one that was without polyps. All have been negative for cancer. The first was at age 55 and one polyp was considered by the physician as about six months precancerous.

Now a study from Germany offers strong evidence that they can prevent colorectal cancers throughout the colon. The study appears in the January 4 issue of Annals of Internal Medicine.

A colonoscopy is one of the most effective cancer screening and prevention exams. That being said, recent studies have raised issues that a colonoscopy may not be useful in detecting some colorectal cancers. However, the issue raising studies were done in Canada. Colonoscopies are the standard in Europe and the US and apparently are better used.

Most in Canada are performed by surgeons and primary care doctors and not gastroenterologists who specialize in the exam. This could be what has caused the problem with the studies.

We definitely have a need for the exam to be performed with the flexible fiberoptic scope with a video camera as the other exams are not as accurate and the fecal occult blood testing often did not see results until cancer was already in place and doing damage. Granted they were lower cost and while there was strong evidence that they were effective, there is still some serious questions about whether more cancer is prevented using the old tests.

There are some problems in the US because gastroenterologists are not required to document the thoroughness of the exam and many people to not receive information after the procedure showing a map of the colon and where the polyps were found. In Germany the quality assurance measures have been introduced nationwide.

I have had both types of exam where I received a complete report and map and then I have not received a complete report. Some standardization needs to be put in place and patients need this complete information.

Since most colorectal cancers take five to seven years to develop on polyps, I agree that the exam needs to take place at least every five years at a minimum. When polyps are found on a regular basis, then I agree that every three years should be normal as are mine. The recommendation is that people should have the exam starting at age 50 unless there are indications for earlier exams.

Do I dare ask questions of or about the gastroenterologist? Yes, everyone should ask at least two questions when the schedule is set for the exam. They are the detection rate for the person performing the colonoscopy and what documentation will be presented upon completion and will it be for the entire colon. If it not for the entire colon, then think seriously about finding another gastroenterologist.

Read about the article on the study here and here. Also view an excellent slide show on colorectal cancer overview here.