What is a colonoscopy and should I get one? | Well actually

COlorectal cancer is the third most diagnosedly diagnosed cancer and the third cause of cancer death in the United States, according to cancer Research Institute. It is also the third most common cancer in the United Kingdom and represented 12.6% of new cases of cancer in the country in 2021.

Disease rates have dropped overall in recent decades, but in those under 50, rates have increased considerably.

“Individuals born in the 1980s are about twice as likely to obtain colorectal cancer as those born in the 1960s, and individuals born in the 1990s are about three times more likely,” said Dr. Zachariah Foda, assistant professor of medicine and oncology at the Johns Hopkins University School of Medicine.

Experts do not know the reasons for this increase, but the medical guidelines have moved to remedy it. In 2021, the recommended age to start screening for colorectal cancer in the United States – either by colonoscopy or home tests – was reduced from 50 to 45 years. In the United Kingdom, screening is currently offered from 52 years old and will soon be offered to 50 years.

Colorectal cancer is avoidable and “very treatable” if it is detected early, according to the National Cancer Institute. But less than 20% of the 45 to 49 years of age, complaints, compared to 72% of the 50 to 75 year olds. Experts say that some people do not know that they should be detected, and others are nervous as to what colonoscopies involve.

Here’s what you need to know about colonoscopies and colorectal cancer screening.

What is a colonoscopy?

“Coloscopy is an endoscopic procedure, which means that we use a camera at the end of a long tube to examine the colon and the rectum,” explains Foda. The colon itself is about 70 cm long, he said.

Patients are first placed under sedation or anesthesia. Doctors then inserted the scope in their rectum and examine the mucosa of the colon for any anomaly, like masses or small bumps called polyps. These polyps are generally deleted during the procedure.

“The closest analogy is that you have a mole on your skin and that it develops or dumps down, and doctors remove it,” explains Michael Sapienza, CEO of the Colorectal Cancer Alliance, a Colorectal Plaidal group on cancer in the United States.

If a mass is too large to be eliminated during colonoscopy, the doctor will take a sample in the biopsy and will test the cancer.

Coloscopy is an ambulatory procedure, which means that you can go home the same day. The procedure itself generally takes approximately 20 to 30 minutes, but with pre and post-procedure care, the entire process can last two to three hours, explains Dr. Andres Carrion, gastroenterologist at Gastromed Miami.

One of the most common concerns about colonoscopies is that they are painful, explains Carrion. But “intravenous sedatives facilitate the procedure, and there is no pain or discomfort,” he explains.

How do you prepare a colonoscopy?

The preparation of colonoscopy begins about a week before the procedure. Patients are invited to follow a “low residue” diet for this week, which means avoiding food that can make doctors difficult for doctors to see the colon lining well.

“These are things whose body takes a while to get rid of, like seeds, nuts, green leafy vegetables and fiber -rich things,” explains Foda.

The day before the procedure, patients are limited to a clear liquid diet – no solid foods. And the previous night, they take laxatives to fully clean the colon. This can cause a little time on the toilet.

“I hope you have a good reading or a movie you can watch on your phone,” says Sapienza.

What are the risks of colonoscopy?

Coloscopies are generally extremely safe, but as with any medical procedure, there are risks.

According to the Cleveland Clinic, these include an undesirable reaction to the sedative or anesthetic used, to dehydration of the preparation process, to a slight bleeding after a distant polyp or to mass biopsy, abdominal pain, an infection and a perforated intestine.

The latter risk is serious, but rare. A review revealed that there were four intestinal perforations for 10,000 colonoscopies.

At what age do you have to be detected for colorectal cancer?

People at medium risks of colorectal cancer – which means that no family history of the disease and no history of colon polyps – should obtain regular screenings from 45 to 75 years old, explains Carrion.

Above the age of 75, screening needs are determined on a case-by-case basis. According to the health and medical history of a person, doctors can decide that colonoscopies could do more harm than good.

For those who have a family member in the first degree – which means a parent, a brother or a child – diagnosed colorectal cancer, the careers indicate that screening should start 10 years before the age at which your parent was diagnosed. For example, if your mother was diagnosed with colon cancer at the age of 45, you should start to be detected at 35.

Some medical history also put individuals at a higher risk of colorectal cancer, explains Foda. This includes those who have already had cancer and have received chemotherapy, those with inflammatory intestine disease, as well as those with Lynch syndrome (a condition that increases the risk of an individual for many types of cancer) and a polyposis (a condition characterized by a large number of polyps in the colon).

Are there other methods of screening colorectal cancer?

Coloscopies are not the only way to detect colorectal cancer. For those who have an average risk of illness, there are also non -invasive home tests such as COLOGUARD and the fecal immunochemical test (adjustment), explains Sapienza.

For both tests, a patient will receive the test equipment required by post or a doctor. They will then have to mail in a personal fecal sample. The adjustment analyzes if there is blood in the stool. The Cologuard test is looking for both blood in the stool and abnormal DNA that could point polyps or masses in the colon.

How often should you be projected for colorectal cancer?

The frequency for each person depends on a certain number of factors, including the type of test carried out and the medical history.

If a colonoscopy is completely clear, you can usually wait 10 years before your next procedure, explains Sapienza, but consult your doctor.

Current advice recommend that adjustment tests will be repeated each year and that COLOGUARD every three years, explains Sapienza. If the test is negative, no additional analysis is required. If one or the other test comes back positive, you will have to have a colonoscopy. This does not mean that home tests are not effective in detecting the disease alone, explains Foda. “They must be considered as part of the gold stallion for colorectal cancer screening.”

What are the symptoms of colorectal cancer?

In addition to regular screening, familiarizing with the possible symptoms of colorectal cancer, explains Sapienza. This is particularly important for those under 45, which may not yet be eligible for projections.

These symptoms include blood in stool, especially black blood; a change in intestinal habits; anemia; involuntary weight loss; and / or the discomfort of the continuous stomach.

If you start to present one of these symptoms, talk to your primary care doctor or your gastroenterologist and ask for a colonoscopy, he said.

“We must make sure that people are aware of these symptoms,” says Sapienza. “This is a disease where screening saves lives.”