When Should You Get a Colonoscopy?

One of the more common questions J. Timothy Tolland, MD, a board-certified colon and rectal surgeon at the Colon & Rectal Surgery Associates receives is ‘when do you get a colonoscopy?’

“The easiest answer is we follow the American Cancer Society guidelines which say that you should start getting colonoscopy at age 50,” says Dr. Tolland. “Every year in the U.S., 50,000 people die of colon cancer, second only to lung cancer which is about 150,000.”

What is a Colonoscopy?

A colonoscopy is a diagnostic test to examine the interior lining of your large intestine (comprised of the colon and rectum). During the test, a long, thin, and flexible tube (colonoscope) is inserted into the rectum. A small camera attached to the instrument enables the colon specialist to see throughout the length of the colon.

Colonoscopy is employed to identify and remove precancerous growths or polyps and to detect the presence of colon cancer, diverticular disease, and colitis. A tissue sample (biopsy) can also be obtained during the exam.

Why is a Colonoscopy Performed?

colonoscopy graphicA physician may perform a colonoscopy to:

Examine the intestinal canal for problems and to help determine the potential cause of abdominal discomfort, bleeding in the rectum, constant constipation, and persistent diarrhea
Screen for polyps (tissue growths in the colon) and colon cancer
Detect and remove any additional polyps in patients who have had polyps before to lower the chances of colon cancer
Investigate the cause of iron deficiency anemia (a lowered blood count stemming from the loss of iron)

“I explain to patients that this is a life-saving procedure,” says Dr. Tolland. “We don’t know who is going to get colon cancer in the United States.”

Who Should Get a Colonoscopy?

Although colorectal cancer can affect people in any age group, your risk of developing colorectal cancer increases progressively from age 40 and spikes quickly after the age of 50, especially if you have a family history of colorectal cancer.

With nine out of ten colorectal cancer patients older than 40, Dr. Tolland is quick to point out the critical nature of the test.

“We explain to patients that this is a mandatory test,” he says. “You should get it at age 50. Generally, it’s done every ten years as long as nothing is found and you don’t have it in a first-degree relative (family member).”

Other colorectal cancer risk factors include:

A personal medical history of:

  • Ulcerative colitis
  • Intestinal polyps
  • Breast, uterine, or organ cancer

Many polyps and early-stage cancers do not cause any symptoms making it imperative that you incorporate colorectal cancer discovery measures into your routine physicals after the age of 50.

“I go through the process with patients, and I explain the need for this test,” says Dr. Tolland. “Most times, patients aren’t going to have anything. Maybe 20% of patients will have a polyp found their first exam. Sometimes, during their first test they will have colon cancer. We take (the cancer) out and follow those patients a little more closely, every five years.”

What Should You Expect After a Colonoscopy?

Dr. Tolland with patientYour physician will go over the results of your colonoscopy and sit down with you to explain them.

A negative outcome:

If no irregularities were found in your colon, your colonoscopy will be deemed negative. In the absence of any common risk factors (not including age), your doctor may recommend you wait ten years before undergoing a repeat exam.

However, if your doctor was unable to completely visualize the lining of your colon due to residual stool, you may be asked to repeat the procedure sooner.

A positive outcome:

A colonoscopy is considered positive if unusual tissue or polyps were found in your colon. The majority of polyps are not cancerous. However, some may represent the warning signs of cancer. The polyps extracted during colonoscopy are analyzed in the lab to conclude if they are malignant or benign.

The size, characteristics, and the number of polyps will determine if you will be required to undergo a more frequent and comprehensive future screening regimen.

Depending on your other general risk levels for colon cancer, if just a few small polyps are found (less than half an inch in diameter), you may only need to repeat the procedure in five to ten years. If larger and more numerous polyps are discovered with particular adverse cellular properties, your doctor may call for a repeat colonoscopy in three to five years.

If your physician removes one or more cancerous polyps during your colonoscopy, you could need a second exam in just three months to a year.

Better to Be Safe Than Sorry

Colon cancer has a 92% survival rate if detected early on, which is why Dr. Tolland takes the time to explain to his patients the importance of having the test once they turn 50.

“People want to know why they need to have this (test),” says Dr. Tolland. “This is a disease you shouldn’t have to die from. Colon polyps are little benign growths that occur in the bowel, and they take five to ten years to grow into colon cancer.

“We have all this lead time to prevent people from getting colon cancer, and that’s the whole gist of why you want to have a colonoscopy done.”

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