I’ve been in private practice for more than 20 years, and if I’ve learned one thing it’s that some people will never agree to have a colonoscopy. Patients I’ve seen since we first opened our practice, who trust me to handle every other aspect of their healthcare, ignore my strongly stated advice to have a colonoscopy at the appropriate time. Sadly, I tend to lose (on average) two of these individuals to colon cancer each year.
Colon cancer is diagnosed in more than 140,000 Americans each year. If the cancer is found early, while still in a local growth (called a colon polyp), during a routine screening colonoscopy, the survival rate at five years is 91-95%. And that often is treated by a polyp removal or surgery to remove part of the colon. If a patient waits until symptoms like bleeding, pain, or unexplained weight loss occur, the cancer has usually spread, and the five-year survival rate, even with chemotherapy and/or radiation added to the surgery, goes down to 8%.
Still, even armed with those facts, some people still refuse a colonoscopy. Why?
Here are some common reasons:
1. Fear of pain. That’s easy, there isn’t any.
2. Fear of embarrassment. It really is not embarrassing. The folks at the centers where these are held do this procedure all day long and are very matter of fact about the whole procedure.
3. Fear of anesthesia. The anesthesia is mild and usually quite well tolerated. It’s just like taking a nap, and when you wake up you get to eat!
4. Fear of the prep involved. Granted, this is a legitimately obnoxious process, but short-lived and handled in the privacy of your own bathroom. Some of the older preps were more unpleasant. Now there are a few options, but a lot of doctors recommend a very large dose of a laxative (polyethylene glycol mixed with Gatorade.)
5. Fear of the cost. Most insurances offer fairly good coverage for this procedure now because they recognize that a screening colonoscopy is far less expensive than treating a member for advanced colon cancer. Still, if you have concerns, talk to the surgery center or hospital about payment plans; most places are happy to work with you.
The bottom line (no pun intended) is this: Colon cancer is the second most common fatal cancer to be diagnosed in this country, exceeded only by lung cancer (mostly affecting smokers), so if you do not smoke, colon cancer is the most likely cancer to kill you. But it’s completely unnecessary to die of colon cancer (in most situations). With proper screening, almost all colon cancer deaths could be completely avoided.
Dr. Beth Hodges is a family practice and palliative care/hospice physician in Asheboro, N.C., as well as a part-time medical director for HealthTeam