Should you say no to this cancer test?

Any medical procedure has its dangers, but the benefits can be compelling.

Dangers of common cancer test

About 45 years ago, my father was told he had bowel cancer. 

As a teenager at the time, I didn’t think much of it, but as I got older, my family doctor informed me that because my father was under 45 when diagnosed, I was in the ‘high risk’ group when it came to contracting bowel cancer. 

This meant my chances of getting colon cancer jumped from about 20 to one, to around eight to one. 

That’s what I was told 20 years ago, and since turning 50, I’ve had a colonoscopy every three or four years. I’ve now had four of them and due for a fifth. 

In recent years, however, the debate about the wisdom or otherwise of a regular colonoscopy has intensified. Proponents say it’s the most conclusive way of detecting bowel cancer. Opponents say its effectiveness has never been studied and that repeated examinations increase the chances of other complications. 

Because I’m always going to be in the ‘high risk’ group, I’ve tried to follow this debate carefully, slightly incensed that it’s even going on and that medical experts can’t seem to give a unified view. 

If you’ve never had a colonoscopy let me tell you that it’s not a big deal. A day before the procedure, you are required to fast and drink a salty, lemony, unsavoury liquid that flushes your bowel. That’s the worst part of a colonoscopy.  

The following day, you attend a surgery where an anaesthetist puts you to sleep and, while you’re out, a doctor who specialises in such procedures passes a tiny camera on a long, flexible tube along your large bowel. Images appear on a screen and the doctor checks for abnormalities. 

During the colonoscopy, if the doctor sees anything worrying, a small amount of tissue may be removed for analysis, and abnormal growths, or polyps, can be identified and removed. 

If you go in around lunchtime, you’ll be home for dinner, but you won’t be allowed to drive for about eight hours. 

We also now have a thing called the Virtual Colonoscopy, which uses an MRI or CT scanner to create images of the colon. They are not as accurate as normal colonoscopies and involve exposure to radiation. 

Most people who have colonoscopies don’t have bowel cancer, and bowel cancer is usually detected only after further testing, such as with an abdominal scan. A sudden blockage of the bowel or blood in faeces are among the most common early signs of bowel cancer. 

In short, a colonoscopy is primarily used to find cancerous and precancerous growths in the colon, so is considered an early detection procedure. Given that colorectal cancer is slow-growing, it can usually be treated when caught early. 

You should also be aware of the Federal Government’s National Bowel Cancer Screening Program. Eligible people aged between 50 and 74 are sent an easy-to-use test kit to complete at home. 

To be invited to take part in this free program, your name will be drawn from either Medicare or Department of Veterans’ Affairs enrolment records. The government aims to have the program fully implemented by 2020 with two-yearly screenings offered to participants. 

If any abnormalities are detected, a colonoscopy may be recommended anyway. 

So where does all this leave you? 

The best answer is to talk to your doctor. They will ask questions about your family history of cancer, your bowel habits, your diet, and whether you’ve suffered from anything like Crohn’s disease or diabetes. 

Your doctor will be assessing your risk of contracting bowel cancer. The higher your risk, the more educated you need to become on the topic. Don’t just accept what you are advised. 

Such is the difference of opinion about colonoscopies that you need to be fully informed on the dangers and any alternatives. You don’t ever want to say to yourself: “I should have known better.” 

Some medical websites, for example, will ask the question: “Why avoid a colonoscopy?” They’ll then list superficial reasons such as the cost, the nervous anxiety generated and the inconvenience. They often fail to mention the fatal possibilities. 

Other websites that take the alternative side of the argument and are often not directly linked to the medical industry, claim that more people die or are injured by colonoscopy-related complications than die annually from colon cancer. 

Such complications include a reaction to the sedative used, bleeding from the site when a tissue sample is taken or a polyp removed, or a tear in the colon wall. 

For the record, the death rate from colonoscopies in America is estimated at about one patient for every 1000 procedures. 

These sites also suggest that colonoscopies are massive sources of income for doctors and anaesthetists, and are therefore strongly encouraged by them. 

Among my doctor friends, I have one who emails his friends regularly reminding them to get a colonoscopy and even offering discount group rates, and another who is 65, has never had one and says he never will. There’s no history of bowel cancer in his family and he has had a strict diet for many years. That’s good enough for him. 

And so there you have it. Arm yourself with the facts and be aware of your own susceptibilities. Don’t rely on any one source of advice. And know the little things, like whether or not a daily dose of raw turmeric is good or bad for you. 

And once you’ve googled that question, you’ll be on your way.

Do you believe in colonoscopies?

Disclaimer: This article contains general information about health issues and is not advice. For health advice, consult your medical practitioner.



    To make a comment, please register or login
    5th Apr 2018
    What are the costs?
    5th Apr 2018
    It generally is free but you might have to wait a while. Private hospital charged the excess only which is payable once a year when one uses the hospital for the first time.
    18th Apr 2018
    I am due for my 5 yearly check up right now and I am going public. If I use my private insurance (I have a $500 excess) I WILL be charged the $500 even though it is a day procedure.

    Just found out that HBF (my insurer) has now changed the rules and the excess is payable on day procedures as well...not just if you are admitted and stay overnight. So beware those who are with private health insurers....others may now be doing the same may pay to check if you are with another insurer other than HBF.
    5th Apr 2018
    I have also had a colonoscopy in the past and the absolute worst part was the disgusting liquid you had to drink before. The procedure was painless and over before I knew it. I would certainly have another colonoscopy if my Dr advised it.
    5th Apr 2018
    Been using the Federal Government’s National Bowel Cancer Screening Program for a number of years now and trusting that suffices. Wouldn't hesitate to have a colonoscopy if required.
    8th Apr 2018
    I have used it once and will do it again. 'They found traces of blood in the samples I sent for testing. Fortunately It was a benien polyp. I have an immediate relative who has had 2 bowel cancer operations and a course of chemotherapy.
    5th Apr 2018
    The FOB samples, done regularly, are a simple prong of several available tests whether or not there are any symptoms. A colonoscopy appears to be the right test to rule out a tumour in persons at risk. I had 3 colonoscopies over several years, with polyps removed. The fourth colonoscopy resulted in a seriously lacerated spleen. I told staff before leaving the hospital I was having a lot of pain which was assumed to be wind. I fainted outside on the footpath with what was quickly diagnosed as heavy internal bleeding. My bp was seriously low, now wonder I felt so dreadful. A CT scan showed up the problem and a surgeon was called in to prepare to remove the spleen. I opted to wait a few hours before agreeing, and being under close observation for a few hours, the bleeding stopped and an operation avoided. I've had two colonographies since then. They are not nice as you are awake while they insert a tube to fill the bowels with gas so the photographs will be easier to read. Quite strong abdominal distension has to be tolerated. I am never to be scoped again. My latest gastroenterologist told me he had 2 similar accidents and ruptures are part of the risk. So what's the use of telling patients about these risks? The risk of not letting the gastro's have a good look could be worse than the risk of a nasty side effect. The gastro's are making a fortune out of it but just think of the lives saved - that's the upside.
    8th Apr 2018
    I was given medium strength sedation and drifted off to sleep before they inserted the tube.
    5th Apr 2018
    If your inherited risk is high it is probably essential, but as one on my last colonoscopy, ended up with a perforated bowel & a week in hospital, I would be thinking twice before going ahead.
    5th Apr 2018
    I am having one of these next Monday. As you say worst part is the preparation but its better than cancer. My health fund pays all hospital costs and the gastroenterologist and the anesthetist are in the Gap Access Scheme so I shoudnt be out of pocket and I dont have an excess or a co payment. I should add I have just paid over $4300. for my husband and I for 12 months private health cover. I feel lucky to be able to do this and not wait arond.
    5th Apr 2018
    Just to make your text more accurate, MRI does not involve radiation; CT scanning does. I don't think MR colonography is as good as CT colonography however for bowel cancer, and I suspect that it is not covered by Medicare.
    Certainly colonoscopy is not always a bed of roses, and the death rate of 1 in 1000 procedures is probably dwarfed by the rate of other complications. The big problem is that the large bowel is teeming with germs and if you tear the wall during colonoscopy, you have instant and often really nasty peritonitis. These complications are more frequent in elderly people with fragile tissues.
    5th Apr 2018
    CT colonography shows up anything in the bowel larger than 1 cm which is better than nothing. I;ve not heard of MRI colonography and I have to pay $600 upfront for my colonographies because they are not covered by Medicare or private health fund. That is a very large impost for persons who have no other option and a disincentive to have potentially life-saving checks with a potential high cost burden on the health system.
    5th Apr 2018
    I can't stomach the prep stuff you have to drink. In fact, last time I had to have a colonoscopy, I almost got all the prep stuff down, but then vomited it up so hard I split something in my esophagus - a Mallory-Weiss tear they called it - for which I had to have an upper endoscopy at the same time as the colonoscopy was done, but by a different surgeon. I wondered what would happen if they met in the middle! Not everyone's experience, but certainly mine! And I'm not a drinker!
    8th Apr 2018
    I almost vomitted up the prep too. It is quite acidic and I have reflux I have to stay on a diet and take medication or I vomit within an hour of eating something I shouldn't have. After over 10 years my diet is still trial & error.
    5th Apr 2018
    I had two of the home kit poo tests come back negative. However I landed up in A&E needing a 3 pint blood transfusion.This was followed a CT scan and an MRI, and then an x-ray, all of which showed nothing. However a good doctor told me I should have a colonoscopy. The gastroenterologist who examined me told me straight away that I had bowel cancer but sent off a path specimen anyway- it confirmed cancer. I had an operation which revealed stage 2 cancer. Don't knock colonoscopies, say I. Every procedure carries risks.
    Medibank payed out for the colonoscopy.
    11th Apr 2018
    No I don't believe in them, I prefer prevention, eat more fibre, lots of fruit and veg. I was told once to go for one for my IBS, I decided against it because I was not going to take any medication that they might have suggested, instead I beat it myself through diet and exercise.
    18th Apr 2018
    You can eat all the good food you like but if you have inherited the gene (which I have) the chances are you may get it.

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