Preventative Medicine Saves Lives

When should I get a colonoscopy? How often should I get one? Do I really need one if I don’t have symptoms and feel good?

I often hear questions like these. Many people ask me when they should have a colonoscopy, and some do not understand why colonoscopies are important especially if they feel well and do not have a family history of colon cancer. I had a 55-year-old patient a while back that was really opposed to having a colonoscopy because he felt well, and he didn’t have any family history of the disease. After 5 years, he reluctantly went for the procedure (with the help of some coaxing by his wife and me) only to find that he had a large precancerous polyp in his sigmoid colon (the lower portion of the colon). He is now the biggest proponent for the test and makes sure all of his friends and colleagues have one.

Colonoscopies are performed to screen for colon cancer. Colon cancer is the most prevalent cancer among all adults in the U.S. The most common cancer in women is breast cancer, and the most common cancer in men is prostate cancer. However, if you look at men and women together, you’ll find that the most common cancer in the U.S. is colon cancer. It usually begins as a precancerous polyp that changes to become adenocarcinoma  over several years. The best tool to screen for colon cancers and risky precancerous polyps is the colonoscopy. It is such a good test because the physician performing the test can actually see the inside of your colon through a scope where the image is projected on a video screen. They cannot only visualize the colon, but they can take biopsies of atypical sites and even remove precancerous polyps before they change into cancer.

People sometimes believe that if they feel good, then they don’t have a problem and they couldn’t have cancer. The truth is that a cancer such as colon cancer usually starts out very small and grows over many many years. When it becomes large enough, it can block the colon or grow through the wall, which then can cause symptoms such as pain, weight loss and change in bowel movements. You do not want to wait until you have symptoms to have preventative testing.

Medical care has changed significantly over the past 50 years. It took many years to move medical care from focusing on just treating the ill to preventing disease altogether. Years ago, physicians would not treat high blood pressure or elevated cholesterol levels until a patient had a heart attack or stroke. Diabetes wasn’t typically treated until someone became symptomatic with dizziness and changes in vision. In many of these instances, it was too late.

We have definitely learned a lot in the last 50 years! Medical studies have shown that if we screen for colon cancers via colonoscopy when a person is 50 years of age, we can prevent a significant amount of colon cancer from occurring. We can identify polyps early that have the potential to grow into cancer, and we can treat early cancers that have formed but have yet to progress to cause symptoms. We have also learned that if people have a primary relative (parent, grandparent or sibling) with colon cancer or polyps, they should be screened earlier. Generally speaking, these people should be screened at age 40 or 10 years earlier than the relative who was previously diagnosed with colon cancer or polyps – whichever age is earlier. For example if Sam’s father was diagnosed with colon cancer at 47, Sam should plan on having a screening colonoscopy at 37. If Sally’s father had colon cancer at 59 she should have a colonoscopy at 40.

If your colonoscopy was determined to be normal then you should expect to repeat it in 10 years. If a precancerous polyp or other abnormality was identified and treated, your physician will use a different schedule. These guidelines are part of the general guidelines published by The American Cancer Society. There are many societies and organizations that make recommendations in regard to cancer screening tests. The majority of the active practicing medical professionals in the U.S. follow the American Cancer Society Guidelines. From time to time, one organization may publish new guidelines that contradict another, and this is when we see the controversies appear in the media such as changes in recommendations for mammograms. I will delve into details on these issues in future blog posts.

Stay Healthy!…….DocMatthew

Click here to sign up to receive DocMatthew’s blog posts sent right to your inbox once a week!

http://docmatthew.us6.list-manage.com/subscribe?u=aba0188a0e&id=2220c6c988

Medical Disclaimer

The content of this website is provided for general informational purposes only and is not intended as, nor should it be considered a substitute for, professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider.