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March 13, 2017

The Life-Saving Test that Gets No Respect

by John Hastings

I can’t wait to get my colonoscopy! is what no one said, ever. Most people would rather not think about getting a colonoscopy at all, which is probably why more than 20 million eligible Americans (people between the ages of 50 and 75, or younger if there’s a history of colon cancer in your immediate family) have yet to be screened. That’s too bad, because colon cancer is the second leading killer in the United States after lung cancer, and many of those deaths don’t have to happen, says Jerald D. Wishner, MD, medical director of the Colorectal Cancer Program and Colon and Rectal Surgery at Northern Westchester Hospital. “With screening, colon cancer is one of the most preventable cancers,” Dr. Wishner says.

Considering that people only need to get a colonoscopy once every 10 years, you’d think we wouldn’t be so reluctant to sign up. One reason, says Dr. Wishner, is that many people have outdated ideas about what the procedure involves. In honor of Colon Cancer Awareness Month, here are four myths about the exam—and the reassuring reality.

Myth: If I feel fine, there’s no need to be screened.

Reality: Colon cancer begins with small growths called polyps inside the colon, and it can take five to eight years for those polyps to turn malignant. Once they do, there are usually no symptoms until the cancer has become more advanced. The promise of a colonoscopy is that, if pre-cancerous polyps are found, the doctor can snip them off during the procedure. “With a test like a mammogram, the hope is that you’ll find cancer early,” says Dr. Wishner. “Colonoscopy takes that a step further by actually preventing cancer from developing in the first place.”

Myth: Getting a colonoscopy is a big hassle.

Reality: Years ago, prepping for the procedure was a major ordeal. People had to switch to a clear liquid diet the day before their colonoscopy; the night before the procedure, they had to drink a gallon of chalky laxative. Now, you can eat more or less normally the day before, so long as you stick to foods that are cleared quickly and thoroughly from your system, such as white rice, white bread and fruits and vegetables without peels, skin or seeds. (Your doctor will give you a more detailed list of allowed foods.) A laxative is still required, but you can split the dose between the night before and the morning of your colonoscopy. “Patients still say prep is the toughest part of the procedure,” Dr. Wishner says, “but it’s much easier to tolerate nowadays.”

Myth: Getting a colonoscopy is painful.

Reality: With the procedure that’s standard nowadays, you’ll be sedated and an anesthesiologist will be present, Dr. Wishner says. What that means: You’ll feel no pain. Recovery is fast, with just minor post-procedure grogginess and a little bloating, he says. “Most people barely know they’ve had the procedure.”

Myth: Getting a colonoscopy is embarrassing.

Reality: Okay, there’s no arguing with that one—for many people, the mere idea of the procedure is cringe-worthy. Just remember: Thanks to the sedative, you’ll sleep through the procedure, which will minimize any potential awkwardness. Besides, just how much are you willing to risk because of a little self-consciousness? “Even if you do feel a little embarrassed,” Dr. Wishner says, “it’s a small price to pay for protection against the second deadliest cancer.”