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Thursday, Nov 27, 2014
Health & Fitness

When should I have another colonoscopy?


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How often you have a colonoscopy depends on what was found during your first one. If no polyps or only non-cancerous ones were found, you won’t need another one for 10 years — unless you experience symptoms or your family history warrants more frequent exams.

That’s good news for most of us, who dread this kind of exam.

But look at the procedure another way: This simple screening can catch non-cancerous polyps that would likely become cancerous if left alone. For 80 percent of patients, removing polyps prevents cancer from ever developing.

The truth is colon cancer is one of the most common cancers and one of the most deadly. It is also one of the most preventable. And with the increased awareness of the importance of screening, fewer people are developing colon cancer, so the death rate for colon cancer has dropped significantly in the last 15 years.

Ideally, everyone will have a baseline screening at age 50. The frequency of any future screenings depends on how many polyps are detected during your exam and your family medical history. If you have no polyps or a hyperplastic polyp (no potential to turn into cancer) you would return in 10 years. If you have a tubular or tubulovillous adenoma, depending on size and the number, you would typically return in three or five years.

Even if your first screening was clear, you should talk with your physician immediately if you have symptoms before your next screening. For most people, colon cancer has no symptoms, which is why it is one of the deadliest cancers. But the following symptoms may indicate colon cancer: abdominal pain and tenderness in the lower abdomen; blood in the stool; a sudden change in bowel habits; weight loss with no known reason; or narrow stools.

Several tests can hint if there is cancer in the colon, but the most effective screening tool is colonoscopy, which allows your doctor to look at your rectum, the inner lining of your colon and the lower part of your small intestine with a colonoscope, a thin, flexible tube with a small video camera attached. If necessary, tissue samples will be collected (biopsy) and abnormal growths (polyps) will be removed during the procedure. Usually, 30 to 40 percent of patients undergoing a colonoscopy have polyps that need to be removed. The procedure takes about 20 minutes and you are completely asleep the entire time.

For most of us, the preparation for the screening is the most dreaded part of the exam. But before your doctor can perform the exam, you will need to clean out your colon so the intestines are completely clear. Colon prep, a solution you drink that will cause you to empty your intestinal track, usually takes one day and is taken the day before the test. Plan to stay home during your prep time since you will need to use the bathroom often.

Both men and women can get colon cancer. It is the second-most common cancer affecting women (after breast cancer) and third-most common cancer affecting men (after lung and prostate). But screening finds the polyps before they become cancerous. That early diagnosis and polyp removal equates to a complete cure for most people.

Dr. Chae is assistant professor in the Division of Digestive Diseases and Nutrition at the USF Morsani College of Medicine and is a physician in the USF Small Bowel/Lower GI Motility Center.

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