There is one difference – a big difference – between a colonoscopy and most other types of cancer screenings.
During a colonoscopy, a physician can find and remove the causes of colon cancer, while other tests detect cancer that is already present.
“A colonoscopy not only screens for cancer, but provides a way for us to remove the polyps that often lead to the disease,” said Thomas Wilder, M.D., of Central Kansas Surgical Care. “You remove the polyps, you prevent the cancer.”
Since March is National Colorectal Cancer Awareness Month, Dr. Wilder is using the opportunity to share this information with the community. Central Kansas Surgical Care is part of the Central Kansas Medical Center family.
“There is no screening that is 100 percent,” Dr. Wilder said. “But a colonoscopy is as close to 100 percent as you can get in finding colon cancer. That percentage is in the upper 90s for finding polyps of a centimeter or larger.
“With other screenings, such as a mammogram for breast cancer, the goal is early detection of a cancer that is already there,” he added. “A colonoscopy is one of the few tests in which you can find the culprit before it becomes a cancer. It is an opportunity to prevent the cancer from developing in the first place.”
The incidents of colorectal cancer have dropped considerably, in part, because polyps are being removed during colonoscopies, Dr. Wilder noted.
“We do about 100 colonoscopies a month,” the surgeon said. “We find cancer in one or two of these patients but we find the polyps that cause cancer in about 50 out of the 100. This is so significant because it means we can help prevent colon cancer in 50 people a month.”
Dr. Wilder realizes that some people are leery of colonoscopies because of the nature of the procedure. The physician uses a thin, flexible, hollow tube that is equipped with a tiny video camera to examine the entire colon. A sigmoidoscopy involves only the lower portions of the colon.
“In the past, they didn’t sedate the patient and the prep was awful,” Dr. Wilder said. “But it is completely different today. An anesthetist provides sedation that doesn’t cause a hangover effect. The procedure takes less than a half hour.”
In addition, gone are the days of drinking a gallon of unpleasant-tasting solution to cleanse the colon the day before the procedure. Instead, there are many options that have no flavor and the large volume is no longer necessary.
“I use a powder that can be mixed with virtually any beverage,” Dr. Wilder said. “There is no taste at all.”
He added that patients don’t need to feel embarrassed. They are completely covered during the test, and the physician’s attention is on a computer screen that depicts the inside of the colon.
A screening colonoscopy is recommended every 10 years beginning at age 50 for those who have had no symptoms and no family history of colon cancer. A surveillance colonoscopy is strongly suggested for those who have had polyps in the past or have a significant family history.
“If your mom or dad had colon cancer that was diagnosed at age 50, you should be screened at age 40,” Dr. Wilder recommended. “It should be 10 years earlier than a primary relative’s diagnosis.”
The American Cancer Society reports that excluding skin cancers, colorectal cancer is the third most common cancer diagnosed in both men and women in the United States. The 2010 statistics indicate that there were 102,900 new cases of colon cancer - 49,470 in men and 53,430 in women.
The new cases of rectal cancer totaled 39,670 – 22,620 in men and 17,050 in women.
Colorectal cancer is often highly treatable, Dr. Wilder noted. If treated early, the five-year survival rate is about 90 percent. But since many people are not getting tested, only about 4 out of 10 are diagnosed at this early stage when treatment is most likely to be successful.
“The American Cancer Society indicates that we could eliminate about 90 percent of colorectal cancers if more people were screened,” Dr. Wilder said. “We encourage everyone to get tested before polyps turn into cancer.”