Colonoscopy

Colonoscopy is the preferred diagnostic tool for colon cancer screening. The American Cancer Society recommends colorectal cancer testing for everyone starting at age 45, though some people with certain risk factors may need to start at a younger age. You should be screened at an earlier age if you have a family history of colon cancer or polyps. 

A colonoscopy is a medical procedure that physicians use to detect abnormalities or changes within the colon, or large intestine, and rectum. Because the physician is able to remove polyps during the test, a colonoscopy is one of the only procedures that diagnoses and treats the disease at the same time.  During this procedure, the physician inserts a colonoscope, a long and flexible tube, into the rectum. The tube features a video camera on its end, which allows the doctor to view the entire inside of the colon as the tube moves. If any abnormal tissues or polyps are found along the way, the physician can use a scope to remove them as well as to take biopsies or tissue samples in the process.  

One of the main patient concerns when scheduling a colonoscopy is whether deep sedation or conscious sedation will be used. Deep sedation with an anesthesiologist present is one of the safest ways of performing a colonoscopy.  Propofol is the most common anesthetic used to achieve deep sedation.  This drug must be administered and monitored by an anesthesiologist or CRNA. The anesthesiologist can focus on patient comfort and safety while monitoring the patient’s response to the cardiovascular, respiratory and neurologic changes that occur during the use of intravenous (IV) propofol.  Deep sedation with propofol can positively influence both the patient’s experience and the finding of polyps. In conscious sedation, the patient is given a drug to numb and relax them, but they remain awake throughout the procedure.  The patient will be able to respond to verbal commands, will wake fairly quickly, and generally will not remember the procedure afterwards.

Although other diagnostic exams exist for looking at the colon, such as MRI and CT scans, there are a number of reasons why a colonoscopy is preferable. The primary reason is because it is a minimally invasive procedure that allows for a thorough view of the entire rectum and colon. Another benefit of the colonoscopy is that many issues can be dealt with or removed at the same time. Some of these issues include biopsying tissue or removing polyps or other abnormal tissues. Some small colon cancers are also removable by colonoscopy, which eliminates the need for more invasive procedures.

Physicians recommend colonoscopy to screen for colon or colorectal cancer, as well as to investigate other signs and symptoms in the intestinal tract. Colonoscopy can help physicians explore potential causes behind abdominal pain, chronic constipation, rectal bleeding, diarrhea and many additional intestinal problems. Physicians recommend a colonoscopy every 10 years as a vital screening for colon and rectal cancer.