Colon Cancer Screening: Why It's Important and What to Expect

As we wrap up Colorectal Awareness Month this March, it is important to know that a regular screening colonoscopy can prevent colorectal cancer by catching and removing precancerous polyps, which can develop into cancer over time. By getting screened routinely, you can proactively address these growths and decrease the risk of developing colorectal cancer.

V. Karlos Arcos, M.D., is a board-certified colorectal surgeon with INTEGRIS Health Baptist Medical Center. Below, he answers some of the most commonly asked questions about colonoscopies.

How a colonoscopy works

What to know: A colonoscopy involves using a long, flexible tube called a colonoscope with a tiny camera attached to the end. It helps diagnose issues and prevents problems by removing growths before they become cancerous.

• You are positioned comfortably on your left side. The anesthesiologist administers intravenous medications for moderate sedation. You will sleep safely through the procedure with little to no pain or discomfort.
• Next, your doctor inserts the colonoscope into the anus and guides it through the rectum and large intestine (colon).
• The camera helps detect any abnormalities in the colon, such as polyps, masses or inflammation.
• Any polyps or suspicious areas are removed or biopsied with small tools that pass through the scope.
• In the event your doctor finds cancerous appearing tissue, a biopsy helps collect tissue samples to be examined by a pathologist. 
• The entire procedure typically takes 30 minutes, although some are as short as 15 minutes or as long as 45 minutes to an hour.

More reading: Several years ago, the American Cancer Society lowered its recommended screening age for colon cancer from 50 to 45. 

Colonoscopy prep

What to expect: Preparing for a colonoscopy is vital for a successful procedure. It usually includes dietary adjustments and a bowel-cleansing process to ensure clear visualization of the intestine. 

• A low-fiber diet several days before your screening minimizes residue in the colon. Low-fiber foods include white bread, white pasta, white rice, lean protein or vegetables with the skin removed.
• A clear-liquid diet begins the day before the colonoscopy. Examples include water, clear broth, gelatin or popsicles (without dyes or additives).
• An oral laxative formula the night before clears the colon of stool. There are many types of colonoscopy prep solutions, but they generally include an osmotic laxative and electrolytes.
• Osmotic laxatives draw more water into your colon to soften stool and trigger the muscles to expel the stool.
• The loss of fluids through repeated bowel movements can cause dehydration. Electrolytes help replenish important nutrients such as sodium, calcium and potassium.

The most common laxative used is polyethylene glycol (PEG) 3350 (sold as GoLYTELY, NuLYTELY, MoviPrep and other brands).

• PEG bowel prep is gentler on the intestinal tissue, but it requires drinking large volumes of fluid (up to four liters). 
• Sodium phosphate-based laxatives, such as SUPREP,  require less liquid intake (96 ounces).
• Talk to your doctor about which prep kit suits your needs.

Explore more: Many people dread their colonoscopy. Read this first-person account of a colon cancer screening to help put your mind at ease.

The importance of colon cancer screenings

The bottom line: Apart from skin cancers, colorectal cancer ranks as the third most common cancer among both men and women in the U.S. Colonoscopies help reduce mortality rates associated with colorectal cancer. 

• Over time, abnormal growths or polyps in the colon may turn into colon cancer. Screening and early detection boost successful treatment rates by identifying and removing polyps before they become cancer.
• When caught early, colon cancer is over 90% treatable.
• Colon cancer is a slow-growing type of cancer – most polyps can take 10 to 15 years to become cancerous.
• A colonoscopy detects colon cancer with higher accuracy than at-home screening tests (95 percent vs 92 percent for Cologuard).

Should you see a gastroenterologist or colorectal surgeon?

The big picture: Gastroenterologists, colorectal surgeons and general surgeons all perform colonoscopies. Who does your colonoscopy depends on your medical needs and the expertise needed for a thorough evaluation and any treatment.

• Gastroenterologists excel at spotting colon cancer as well as other intestinal diseases during colonoscopies. Gastroenterologists perform the most colonoscopies compared to other specialists. They can offer medical or endoscopic treatment options. 
• Colorectal surgeons are experts in colon and rectum diseases and cancers. They can perform advanced colonoscopy procedures and perform surgery to treat various problems.
• General surgeons also can perform colonoscopies, especially in rural areas where specialized GI doctors may be less available. This helps ensure access to essential procedures for patients in those areas.

The takeaway: Typically, a gastroenterologist handles most routine screening colonoscopies. However, a colorectal surgeon excels in diagnostic colonoscopies to diagnose or investigate people who have a higher risk of colon cancer. Ask your primary care physician which provider would be best for your colonoscopy.

To schedule a colonoscopy today, call your primary care physician who can refer you to a gastroenterologist or colorectal surgeon. Meet our gastroenterologists and surgeons who specialize in colonoscopies.

To schedule a colonoscopy today, talk to your primary care provider or visit our website.