What is a Screening Colonoscopy?
It's a medical procedure (colonoscopy), that is used to check a person's colon for colon polyps. Colon polyps have the ability to turn to colon cancer if they continue to grow. A person can have colon polyps and may never know it. Polyps usually don't cause any problems or symptoms until they turn to colon cancer. By removing colon polyps found at colonoscopy you can prevent colon cancer from forming. The term "screening" implies it is being done for preventative reasons rather than for symptoms.
Who should have a Screening Colonoscopy?
A person should have a screening colonoscopy starting at age 50 and then at least every 10 years (if no polyps found) until age 75. The decision to be screened after age 75 should be made on an individual basis. If precancerous polyps are found, they will likely need to be re-checked more regularly (every 3-5 years). A person with a first degree relative (parent, sibling, child) who has had colon polyps or colon cancer should have their colons checked starting at age 40 or possibly sooner.
Who should you see for your Screening Colonoscopy?
Does it really matter who does your screening colonoscopy? Answer: Absolutely! This procedure is very operator dependent. You should do some research and ask questions before you choose a physician for your screening colonoscopy. Not all colon polyps are easy to see during colonoscopy. Some polyps are very flat and can hide on the backs of folds and be missed, and some physicians are much better at finding them than others.
Questions you should ask the physician performing your Screening Colonoscopy:
1. What is their Adenoma Detection Rate (ADR)?
2. What is their colonoscopy withdraw time?
3. What is their Cecal Intubation Rate?
See Quality in Colonoscopy for further details.
Where do you get the Answers to these Questinons?
Good question. This data is being tracked by most hospitals. In Cedar Rapids, Iowa, it is being tracked by St. Lukes Hospital and Mercy Medical Center. Most physicians who perform colonoscopy should know this data about themselves, so you could call their office. If they refuse to disclose this information or don't know the answers, then look elsewhere. Most Primary Care Physicians may not know this information. A patient could call the endoscopy unit of their hospital and ask these questions, but it's not certain they would get an answer. Patients should push for this information to be made available to the public. Choosing who performs your Screening Colonoscopy is extremely important. Hopefully this article will take some of the guess work out of it.
Douglas J. Purdy, M.D.
Cedar Rapids, IA