This Minimally Invasive Screening May be the Right Option for You

Once you turn 50, the inevitable happens.

It’s time to schedule your first colonoscopy, one of several ways to be screened for colorectal cancer. The U.S. Preventive Services Task Force recommends that adults between 50 and 75 years of age undergo regular screenings. After 75, the decision to continue screenings is made on a case-by-case basis and largely determined by each person’s risk for developing this type of cancer.

A colonoscopy is one of the most common ways to screen for colorectal cancer and is typically repeated every ten years. Even though the majority of people undergo only three to five colonoscopies in their lifetime, patients are typically not eager to go through the process and try to avoid it if possible.

But skipping out on the recommended screening can adversely affect your health.

“Colonoscopy is the only measure in medicine that not only acts as a cancer screening tool but also prevents formation of cancer through removal of polyps,” says Dr. Igor Naryzhny, a gastroenterologist at Advocate Lutheran General Hospital in Park Ridge, Ill.

Those looking for alternatives to a traditional colonoscopy can opt for a virtual colonoscopy, a less invasive version of the procedure. Since colon cancer is the third most common cancer in men and women, affecting 1 in 20 people, regardless of which option you choose, being regularly screened for colon cancer is what’s most important.

Which Type of Colonoscopy is Right for Me?

Traditional Colonoscopy: A traditional colonoscopy is performed in a hospital’s gastrointestinal (GI) lab. Using a small camera attached to a long, flexible tube called a colonoscope, physicians can inspect the full length of the colon and rectum, see inside the colon, perform biopsies, remove colon polyps (pre-cancerous polyps) and diagnose colon and rectal conditions.

“The benefit of the traditional colonoscopy is that polyps, which are thought to grow into cancer, are removed during the exam. Additionally, other problem areas can also be addressed or biopsied for a diagnosis,” says Dr. Naryzhny.

A traditional colonoscopy is an outpatient procedure that takes less than one hour to perform, and patients are sedated for the screening. Physicians will prescribe a medication to be taken one day before the exam that thoroughly clears out the bowels. Typically, a traditional colonoscopy should be performed every 10 years unless an individual has a family history of colorectal cancer, risk factors or any warning signs of the disease, including changes in bowel habits, rectal bleeding, unexplained abdominal pain or weight loss, inflammatory bowel disease or blood in the stool.

Virtual Colonoscopy: During a computed tomography colonoscopy, otherwise known as a virtual colonoscopy, physicians look for small polyps or growths inside the colon that could turn into colon cancer. This is typically done in the radiology department at the hospital, as opposed to the GI lab.

To perform a virtual colonoscopy, a small, short tube is placed into the rectum so air can be pumped into the colon, which makes polyps and other growths easier to spot. During this screening, contrast is utilized, and a CT scanner takes X-rays of the colon, which are processed by a computer. The computer then puts all the X-rays together to create 3-D images of the colon and rectum for your health care provider to review.

Although a colon cleansing medication is still required, no camera is inserted into the colon and rectum, making this procedure considerably less invasive. Patients do not need to be sedated during a virtual colonoscopy. It’s recommended that individuals who choose this route undergo screening every five years.

“Patients who are poor candidates for sedation or anesthesia, which is utilized during a traditional colonoscopy, might consider a virtual colonoscopy,” says Dr. Naryzhny. “Those on blood-thinning therapy which cannot be interrupted for a traditional colonoscopy are good candidates, as well, although the ability to perform a traditional colonoscopy while taking blood thinning therapy is expanding.”

While it’s less invasive and takes less time to complete, virtual colonoscopies can have some drawbacks.

Physicians cannot biopsy or remove any polyps they find during a virtual colonoscopy like they would doing a traditional colonoscopy. If polyps are found, you will still require a regular colonoscopy. In addition, polyps smaller than 10 mm that will most likely be seen during a regular colonoscopy could be missed during a CT colonoscopy. During a virtual colonoscopy, individuals are exposed to radiation from the X-ray machine, which can slightly increase your risk for developing cancer.

Regular colonoscopies are more invasive, but allow physicians to complete a more thorough examination of polyps, while virtual colonoscopies are less uncomfortable and give physicians the ability to inspect areas outside of the large intestine. When deciding which route to take, it is important to talk with your physician about your comfort level, risk factors and all of your options to choose the best screening tool for you.

Take our Colorectal Health Assessment to determine your estimated lifetime risk.