Colorectal Cancer Screening Can Save Your Life, But Most of Us Just Don't Get It
If there were a test that could prevent a common type of cancer, you would get it, right? And if the screening was for the type of cancer that causes the second-highest number of cancer deaths, nothing could stop you, right? There is such a screening, but only half of those who've been told they need it, get it.
Colorectal cancer is one of two cancers that can be prevented. It can be caught very early and treated successfully, yet only lung cancer causes more cancer deaths. About 140,000 Americans are diagnosed with colorectal cancer each year, and more than 50,000 people die from it. Current guidelines call for everyone to be screened for colon and rectal cancer beginning at age 50, or earlier if there is a family history or other risk factors. It is considered standard preventive care and so generally is covered by insurance.
The most common reasons people put off or refuse colorectal screening fall under one category: fear of the unknown. Many worries are unfounded or manageable, but they are common. Understanding the process will help, so let's address those concerns by answering questions we get from patients:
What tests are offered?
There are two types of colorectal screening tests: those that detect cancer and precancerous tissue called polyps and those that detect only cancer.
- Stool (feces) tests for blood or DNA are designed to detect cancer.
- Colonoscopy, CT colonography, (virtual colonoscopy) and sigmoidoscopy (examines about half of the colon) can detect both cancer and polyps.
These tests are offered at Loyola, and your doctor can advise you on when you need a screening and which type is recommended. Colonoscopy is considered the gold standard in colorectal cancer screening because it allows the physician to test tissue and/or to remove precancerous polyps. That means:
- If polyps (precancerous growths) are found, they can be removed.
- If a tumor or cancer is found, it can be removed in follow-up surgery.
- If nothing is found, you probably don't need to do this again for 10 years.
Loyola performs above the national average on colonoscopy quality measures, such as examining the entire colon, detecting polyps and having good bowel preparation.
If I want to schedule a colonoscopy, where do I go and how do I find a doctor?
Several Loyola gastroenterologists routinely perform screening colonoscopies including:
- Ayokunle Abegunde, MD
- Nikiya Asamoah, MD
- Richard Benya, MD
- Brian Liem, DO
- Amar Naik, MD
- Mukund Venu, MD
Loyola physicians perform colonoscopies at three locations:
- Loyola University Medical Center
- Gottlieb Memorial Hospital
- Loyola Center for Health at Hickory Hills
Will I have to miss work to have a colonoscopy?
You should not work the day of your colonoscopy, and you will need to have someone drive you home after the procedure. Usually, patients may work the day before and the day after. If you do not want to miss work on a weekday, you could look into scheduling a Saturday appointment at Loyola.
What worries people the most?
Because the test is ordered for everyone starting at age 50, very many people who need it have been healthy their whole lives. They've never needed to come to the hospital or medical office for any kind of procedure. They fear what they don't know and worry about what it will be like. The procedure can be done in the hospital or in a small medical office setting, such as at our Hickory Hills and Homer Glen centers. Here is how the appointment usually goes:
- You will be given a gown and an intravenous connection to your arm.
- The doctor will come in and talk with you and explain the process again.
- You will be sedated but conscious. It's unlikely you would have general anesthesia.
- The procedure lasts 20 to 40 minutes, 30 minutes on average.
- Most people don't remember or feel anything.
- When you are finished, you will be given a report on what the test showed.
- Afterward, you may eat whatever you would like, but you cannot drive or go to work.
What do I need to do before the test?
Preparing for the test is crucial to having a complete and accurate test. Patients often hesitate to have a colonoscopy because they are worried about the preparation. A colonoscopy is an endoscopic examination, which is like a camera inside you that shows the inside of the colon. For the doctor to see the entire colon clearly, the bowels must be empty. That requires bowel preparation. Our digestive health team works closely with Loyola primary care physicians, who have clear instructions for what you would need to do the day before the test. We go over your medications, like those for high blood pressure or diabetes, so nothing interferes.
Do I really have to drink a gallon of nasty liquid?
You will need to drink a large amount of a special, prescribed liquid. For the simplest and most effective preparation, you most likely will be instructed to consume only liquids the day before the test.
Will I be nauseated?
It is possible, but we can treat the nausea, even during the procedure.
What if I just can't drink that stuff?
To make the process easier, you usually will be able to drink it in two parts – often the evening before and the morning of the test. We provide contact information in case you have questions or are having difficulty consuming the drink. Someone is always available, even after hours.
Is it true I'll have to stay in the bathroom all the time?
You will want to stay near a bathroom during this time, which can be limiting, but only the evening before until sometime before the exam, usually. Honestly, it isn't as awful as people may think. A colonoscopy will give you peace or mind and may even save your life. It has for a countless number of people who were smart enough to listen and take the test. It's just one day. Just one day that can save your life.
Amar Naik, MD, is a gastroenterologist and director of Loyola's inflammatory bowel disease program. He sees patients at Loyola Outpatient Center and Loyola Center for Health at Burr Ridge. He is a member of Loyola Medicine's digestive health team, which performs more than 6,000 colonoscopies a year.