Should you say no to this 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.

Written by Perko

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