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Putting Off a Colonoscopy?

Has your doctor recommended that you have a colonoscopy for colorectal cancer screening? Have you put it off? If your excuse for not being screened is that the procedure doesn’t sound very pleasant, here are some facts you should know:

  • Colorectal cancer is the second leading cause of cancer deaths, according to the American Cancer Society.
  • 40-50 percent of those who should be screened haven’t done it.
  • Colorectal cancer affects men and women equally.

The good news is, colorectal cancer is one of the most preventable cancers. It begins as intestinal polyps that may or may not become cancer over time. Preemptive removal of the polyps can prevent colorectal cancer, but many polyps go undetected because people don’t have routine screenings.
Rebekah Kim, MD, a colorectal surgeon who recently joined Washington Colorectal Surgery, conducted a research study to correlate prior compliance with colonoscopy screening guidelines to the diagnosis of colorectal cancer.
“Our study showed that very few people get colorectal cancer when they follow the screening guidelines exactly,” Dr. Kim said. “Most of the people in the study had a colonoscopy because they already had symptoms as opposed to being screened preemptively.”
Dr. Kim advises, “Just do it! Don’t be afraid and don’t put it off.”
For most people, the biggest deterrent to having a colonoscopy is the prep. The intestines need to be clean to get a clear picture, which requires following a liquid diet the day before the test, and taking two tablets and drinking two small bottles of prep medication.
“The preparation is so much simpler now,” says Pradeep Gupta, MD, Division Chief of Gastroenterology. “Most people don’t have to drink the large volumes of liquid that we used to use five to ten years ago.
Another big objection from patients—particularly men— is the test seems like an invasion of privacy. “I can’t count the number of times that a patient has told me that part of the body is ‘exit only,’” Dr. Gupta says. “Getting your colon screened is part of maintaining your health, like getting your cholesterol checked.” There are other colorectal cancer screening tests available, but none is as effective as colonoscopy. If any abnormalities are found during other screening tests, a colonoscopy is still recommended as a follow-up. “All roads lead to colonoscopy,” Dr. Gupta says. “This can save your life.”

March is Colorectal Cancer Awareness Month. To request a packet of information on how to schedule your colonoscopy, call 703.558.6848.


These are four primary screening options for colorectal cancer.

  • Fecal occult blood test
    Only picks up about 20 percent of significant lesions.
  • Flexible sigmoidoscopy
    Misses 40 percent of cancers on the right side of the body.
  • Double contrast barium enema
    Misread for flat polyps is very high
  • Colonoscopy
    More than 90 percent accurate. Any precancerous polyps found can be removed at the same time.

Colonoscopy Guidelines

Age for initial screening:

  • Age 50
    Individuals with no family history of colorectal cancer or polyps.

  • Age 45
    African-Americans with no known risk factors.

  • Age 40 or Younger
    Individuals with a first-degree relative (parent, sibling, child) who was diagnosed with colorectal cancer before age 60 or individuals with two first degree relatives diagnosed at any age should be screened at age 40 or 10 years before the youngest relative's diagnosis —whichever comes first. Women diagnosed with breast, uterine or ovarian cancer should talk with their doctor about having a screening colonoscopy at the time of their diagnosis.

  • Follow-up Colonoscopy Interval until the next colonoscopy depends on findings of initial colonoscopy and preexisting risk factors of patient.
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