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My office coordinator, Nancy, says to me, "Someone comes in for a cold, rash, or hangnail, and they leave with an order for a screening colonoscopy." I say to her, "I also order mammograms, do PAP smears, check prostates, and do other health maintenance things– don't those count?"
Are colonoscopies that dreaded? Should the name be changed from screening to screaming colonoscopies?
If colonoscopies weren't fashionable, do you think Katie Couric– in her Jimmy Choo and Stuart Weitzman shoes– would have hers on national television?
Charlottesville Gastroenterology Associates (CGA) sent me some blue wrist bands to signify that March is Colorectal Cancer (CRC) awareness month. (I guess the awareness ribbons are passé now. When the wrist bands go out of style, I think they should make Awareness Sunglasses. I would want mine to be polarized.)
I've even seen commercials on TV with shiny happy people in gowns ready for their colonoscopies. I'm sure the actors aren't stoned, and trust me, I'll be one of those happy people when I turn 50. Why? CRC is the number-two leading cause of cancer deaths, but it's one of the most preventable cancers!
According to CGA– who do, like, five billion colonoscopies a day I'm sure– CRC kills 56,000 Americans a year (that's more than the population of Charlottesville) and there are about 150,000 new cases per year.
"And we're rollin', rollin', rollin' down the colon!" A person's lifetime risk of developing CRC is five percent, and 90 percent of cases occur in people older than 50.
But at least one half of CRC deaths could have been prevented if proper colon cancer screening had been done. Like a dermatology appointment, a snip here and a snip there is all it takes to prevent colorectal cancer. Just as a big ugly mole can become melanoma, a once-harmless polyp can turn into cancer. On average, an adenomatous polyp takes 10 years to turn into cancer, so you want to snip them out early.
"I'm gonna wash that polyp right out of my colon."
In general, a person should get a screening colonoscopy starting at age 50 and have one every 10 years, unless certain types of polyps are found. For African Americans, who are at higher risk, CGA recommends starting at age 45. Those with family history of colon cancer or polyps can start as early as age 20.
Americans in general have this "thing" about the rear end. They don't like the idea of something probing up the anus, into the rectum, and into the colon. How many of you felt your toes curl up just reading this?
Most of my patients say the colonoscopy itself is not bad. They knock you out with "conscious sedation," and most people tend not to even remember the procedure. The prep work is what bothers most people, unless you're from California where having enemas are as normal as eating a salad.
You have to make sure you go to a good gastroenterologist to do the procedure because, yes, like everything, there are risks. The worst-case scenario is the potential for the scope to puncture the colon, but the overall complication rate at Martha Jefferson Hospital is low– something like 1 in 2,700.
When I get my colonoscopy, I'll think of it as a rite of passage– no, scratch that analogy. I will think of it as a great movement in my life– heh. How about I will see the light at the end of the tunnel, telling me I'm healthy?
Whatever analogy, I hope this article doesn't make me the butt of anyone's jokes!
Got a question? Dr. Hook wants to hear from you!
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