Getting to the bottom of colonoscopies: 5 myths debunked

March 27, 2018 | By MultiCare Health System

March is Colorectal Cancer Awareness Month — a good time to talk about a common procedure that many people dread: the colonoscopy.

Colorectal cancer is the third leading cause of cancer-related deaths in women in the United States and the second leading cause in men, but it doesn’t need to be. In fact, it’s one of the few cancers that can be prevented by appropriate screening.

“Colonoscopies are life-saving, preventive tests,” says Kevin Leung, MD, a gastroenterologist with Digestive Health Specialists who performs colonoscopies at MultiCare Covington Medical Center.

A colonoscopy can reduce the risk of death from colorectal cancer by more than 50 percent, yet only one-third of adults are getting screened.

“Colorectal cancer discovered early in its course is completely curable, and the only way to do that is to get screened,” says Eric Johnson, MD, a colon and rectal surgeon with MultiCare Colon and Rectal Surgery.

Starting at age 50, both men and women should get a colonoscopy every 10 years, unless they’re at high risk for colorectal cancer or have a condition that needs to be monitored.

Is the procedure really as bad as its reputation would suggest? In a nutshell, no.

Yet fears and misconceptions persist. Here are the top five.

Top 5 myths and fears

1. Colonoscopies aren’t safe — and they might hurt.

One of the most common concerns people have is that something will go wrong during a colonoscopy.

“It’s one of the safest procedures that we do,” says Dr. Johnson.

“Colonoscopies aren’t painful, just inconvenient,” says Dr. Leung. “With current medications, people are quite comfortable.”

A colonoscopy is a benign procedure performed in an outpatient setting, and only takes about 20–30 minutes. Most patients are mildly sedated and don’t feel any pain.

2. I’m afraid to get a colonoscopy in case I get diagnosed with cancer.

“A colonoscopy in no way increases your chances of being diagnosed with cancer,” says Dr. Leung. “But it can prevent cancer by finding polyps.”

Although one of the aims of colonoscopy is to detect colorectal cancer, the primary purpose is to detect polyps — small growths on the surface of the colon — that could become cancerous. These polyps occur in about 30 percent of the population.

During a colonoscopy, a long, flexible tube is inserted into the anus to examine the entire rectum and colon with a viewing scope. If polyps are detected, they are easily removed while the procedure is taking place to prevent cancer from occurring.

3. It’s too embarrassing.

Physicians and nurses understand that a colonoscopy is a potentially embarrassing experience for patients, and do all they can to make them comfortable — from providing a curtain for undressing, a private room, blankets to stay warm and covered and the ability to select a male or female physician.

It can also help to remember that physicians perform thousands of colonoscopies each year and consider the colon the same way they would any other organ.

4. I won’t be able to drink the prep solution.

The purpose of prep solution is to cleanse the colon so that even the smallest of polyps can be identified and removed during the colonoscopy.

Once upon a time, patients were required to drink a gallon of prep solution the day before the procedure.

Today, most patients drink small-volume preps in split doses: one taken the night before and one the morning of the colonoscopy. This approach is much easier on patients.

5. I’ll have to take a lot of time off work.

Most people only need to miss one day of work for a colonoscopy.

“The prep time is not usually time you can be productive,” says Dr. Leung. But, he points out, you can usually wait until the evening to take the first dose of prep solution, so missing work the day before is not usually necessary.

The day of the colonoscopy is spent at the clinic and recovering from sedation at home, but there are typically no ill effects from the procedure. Most people return to work the next day.

Bottom line: Don’t skip out on screening

According to the American Cancer Society, the lifetime risk of developing colorectal cancer is about 5 percent for men and 4.5 percent for women.

“That doesn’t sound like much,” says Dr. Leung, “But that’s a 1 in 20 chance.”

Still not convinced?

Colonoscopies are one of the most accurate, thorough screening methods available. But the best test is the one you will actually take. Some patients may qualify for noninvasive, at-home stool sample tests, or FIT tests, that are repeated on a more frequent basis than colonoscopy. Talk to your primary care physician about your options.

Remember, the advantage of a colonoscopy is that it can detect polyps, which can then be removed right then and there to prevent cancer. The FIT test detects genetic changes that are sometimes found in colorectal cancer cells, but doesn’t actually detect or remove polyps.