The Top 30 Things to Know Before Choosing Colonoscopy   

  1. Colonoscopy: Unexpected Results From a Major Study, Is It Worth Doing?
  2. Colonoscopy exams do not provide any significant reduction in colon cancer deaths.
  3. Study investigates assumptions about colonoscopy accuracy“Even though we found that we may be overstating the sensitivity of colonoscopy, it still seems to be quite effective at finding many precursors of cancer,” says Carolyn Rutter of RAND – 4/5/2022
  4. Multitarget stool DNA tests increase colorectal cancer screening among previously noncompliant Medicare patients given the reluctance of some patients to have an invasive structural screening test like sigmoidoscopy or colonoscopy a high sensitivity noninvasive screening test with a longer screening interval may provide an effective alternative that could increase the participation in and performance of CRC screening programs research frontiers while several options are available to patients for screening for colorectal cancer and pre-malignant polyps, patient compliance has been lower than that seen on breast or cervical cancer screening. In the United States, a new screening strategy, multitarget stool DNA, provides a systems approach including high cancer and high-grade dysplasia sensitivity in a non-invasive format and an embedded national patient navigation system to support successful screening. Studies to evaluate the clinical uptake and compliance with this test will help inform decisions on applicability to national screening programs.Mt-sDNA test: a stool based assay for colorectal cancer screening. It includes 11 biomarkers (10 DNA and 1 fecal hemoglobin) evaluated as a group in a logistic algorithm to provide a single composite result of “positive” or “negative”.World J Gastroenterol. Jan 21, 2017; 23(3): 464-471
    Published online Jan 21, 2017. doi: 10.3748/WJG.v23.i3.464
  5. Joint Health Supplements May Guard Against Colorectal Cancer
  6. Colonoscopies Miss 6% of Colorectal Cancers
  7. The February, 2012 issue of the journal Anticancer Research reports a lower risk for colorectal cancer in association with increased intake of calcium, vitamin C, vitamin D, vitamin B2 (riboflavin) and folate.Scientists from Canada and China matched 1,760 Canadian men and women with colorectal cancer with 2,481 control subjects. Dietary questionnaire responses were used to quantify the intake of calcium, iron, folate and vitamins A, B1, B2, B6, B12, C, D and E from food and supplements.The team observed diminishing odds of having colorectal cancer in association with increased intake of calcium, vitamin C, vitamin D, riboflavin and folate from dietary and supplemental sources. Those whose intake of calcium from supplements and food was among the top one-fifth of participants had a 41 percent lower adjusted risk of colorectal cancer compared to those whose intake was among the lowest fifth, and for riboflavin, the risk was 39 percent lower for subjects in the highest fifth. Having a greater intake of iron from food and supplements was associated with an increased risk of the disease, in regard to which the authors note that the mineral generates free radicals that attack DNA and damage chromosomes, which contributes to the risk of cancer.
  8. In a ground-breaking new study published in the Feb. 15, 2011 issue of the journal Cancer, researchers from University Hospitals (UH) Case Medical Center and Case Western Reserve University School of Medicine, found that individuals who averaged less than six hours of sleep at night had an almost 50 percent increase in the risk of colorectal adenomas compared with individuals sleeping at least seven hours per night. Adenomas are a precursor to cancer tumors, and left untreated, they can turn malignant.
  9. Consistent exercise associated with lower risk of colon cancer death Consistent exercise is associated with a lower risk of dying from colon cancer, according to a new study led by researchers at the Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis.
  10. ONDON – A five-minute colon cancer test could reduce the number of deaths from the disease by about 40 percent, a new study says.British researchers followed more than 170,000 people for about 11 years. Of those, more than 40,000 had a “flexi-scope” test, an exam that removes polyps, small growths that could become cancerous.The test involves having a pen-sized tube inserted into the colon so doctors can identify and remove small polyps. Researchers used the test on people in their 50s. In the U.K., government-funded colon cancer screening doesn’t start until age 60.Dr. David Ransohoff of the departments of medicine and epidemiology, University of North Carolina at Chapel Hill, North Carolina, said the Lancet findings might make doctors rethink whether the less-invasive flexi-scope test to scan the lower bowel, plus a highly sensitive fecal blood test to scan the upper bowel, could be better than a colonoscopy. Ransohoff was not linked to the study and wrote an accompanying commentary in the Lancet.Ransohoff said the finding that the test only needed to be done once in a person’s lifetime was “striking” and further follow-up was necessary to see just how long this protective effect lasts.
  11. EW YORK (Reuters Health) – Follow-up colonoscopy is both overused and underused, two new studies indicate.Too often, patients at high-risk for colorectal cancer don’t receive timely “surveillance” colonoscopy but there is also over-utilization among low-risk patients who are unlikely to develop colon cancer, researchers found.”This misuse wastes health care resources and risks development of cancers in high-risk patients that might have been preventable,” Dr. Robert Schoen, of the University of Pittsburgh School of Medicine, and senior investigator on both studies, said in a written statement.
  12. he law firm of Hissey Kientz, LLP is warning consumers to immediately stop using Fleet Phospho-soda products for any purpose, including bowel cleansing prior to a colonoscopy.In December 2008 the Food and Drug Administration warned that Phospho-soda products could cause irreversible damage to the kidneys. “Despite the FDA’s warnings about the dangers of Phospho-soda and Fleet’s recall of these products, some colonoscopy patients are still being advised to take Phospho-soda for bowel cleansing,” says attorney David Friend of Hissey Kientz. “Not only does this place patients at risk of kidney damage, but it directly contradicts the FDA’s warning about the safety of these products
  13. 10 veterans test positive for hepatitis after colonoscopies

    CHATTANOOGA, Tenn. 3/27/09 (AP) — The Veterans Affairs department says 10 people have tested positive for infectious liver disease since they were exposed to contaminated colonoscopy equipment.

  14. VA clinic warns of possible contaminant exposureBy BILL POOVEY , Associated Press Writer in Medicine & Health / Health(AP) — Thousands of patients at a Veterans Administration clinic in Tennessee may have been exposed to the infectious body fluids of other patients when they had colonoscopies in recent years, and now VA medical facilities all over the U.S. are reviewing their own procedures.
  15. Accuracy of Colonoscopy Questioned Study Finds the Test Misses Many PolypsFor years, many doctors and patients thought colonoscopies, the popular screening test for colorectal cancer, were all but infallible. Have a colonoscopy, get any precancerous polyps removed and you should almost never get colon cancer.Then, last spring, researchers reported the test may miss a type of polyp, a flat lesion or indented one that nestles against the colon wall. And now, a Canadian report, published in Annals of Internal Medicine, says the test is much less accurate than anyone expected.In that study, the test missed just about every cancer starting in the right side of the colon, where cancers are harder to detect. It also missed roughly a third of cancers arising in the left side of the colon.”This is a really dramatic result,” said David Ransohoff, a gastroenterologist at the University of North Carolina. “It makes you step back and worry, what do we really know?”Colonoscopies are still a highly effective cancer screening test, gastroenterologists say. But instead of preventing 90 percent of cancers, as some doctors have told patients, they actually might prevent more like 60 to 70 percent. [Editorial comment: If so-called experts preached 90% effective for decades, the new 60-70% ‘guesstimate’ is likely exaggerated too]
    Gastroenterologists say that, if nothing else, the study points up the lack of evidence for the common suggestion that anyone who had a clean bill of health from a colonoscopy is almost totally protected for at least a decade.
  16. Surgical removal of small colon polyps is costly and unnecessary Polypectomy (the surgical removal of polyps by colonoscopy) of small polyps found during CT colonography is costly and unnecessary according to a study performed at the University of Wisconsin School of Medicine and Public Health in Madison, WI.A decision analysis model was constructed to represent the clinical and economic consequences of performing three year colorectal cancer surveillance, immediate colonoscopy with polypectomy, or neither on patients who have 6-9 mm polyps found on CT colonography (CTC). The analysis model was accompanied by a hypothetical population of 100,000 60-year-old adults with 6- to 9-mm polyps detected at CTC screening.Results showed that, “by excluding large polyps and masses, CTC screening can place a patient in a very low risk category making colonoscopy for small polyps probably not warranted,” said Perry J. Pickhardt, MD, lead author of the study. “Approximately 10,000 colonoscopy referrals would be needed for each theoretical cancer death prevented at a cost of nearly $400,000 per life-year gained. We would also expect an additional 10 perforations and probably one death related to these extra colonoscopies. There may be no net gain in terms of lives—just extra costs,” said Dr. Pickhardt.”The clinical management of small polyps detected at colorectal cancer screening has provoked controversy between radiologists and gastroenterologists. Patients should be allowed to have the choice between immediate colonoscopy and imaging surveillance for one or two isolated small polyps detected at colorectal cancer screening,” said Dr. Pickhardt.CT colonography is now a recommended test for colorectal cancer screening by the American Cancer Society. “If patients with small polyps are monitored, only five percent of adults undergoing CTC screening will need to undergo immediate invasive colonoscopy,” said Dr. Pickhardt.Source: American Roentgen Ray Society
  17. After removal of the first polyp(s), as many as 48% of the people so treated will develop a new polyp(s) and 27% will go on to develop colon cancer during the next decade
  18. Even one year after the first removal, on reexamination approximately 30% of patients are found to have new polyps or older ones not detected on the first round
  19. Complications from injuries sustained during colonoscopy can harm otherwise healthy patients
  20. After the first cell in a polyp becomes cancerous, an average of ten years must pass before the cancer grows to a barely detectable size of about 1/2 inch
  21. In almost all cases of colon cancer is far advanced by the time the cancerous growth is discovered. This means that in a significant percentage of cases the cancer cells have already spread by way of the bloodstream to other parts of the body. When cancer metastasizes in the manner, the probability that it will eventually kill its victim is vastly increased
  22. Colon cancer is found most frequently in wealthy countries, where people eat rich foods consisting predominantly of red meats, dairy foods, rancid vegetable oils, processed foods, white bread and other refined grains. On the other hand, people following diets providing plentiful amounts of whole grains, vegetables, legumes, and fruits and very little in the way of meats and dairy products develop few cases of colon cancer….MY DIET. In fact, if a person is physically active, have a normal 2-3 bowel movements daily, follows a low fat, high fiber diet, and have no symptoms, the practice of routine colonoscopy or sigmoidoscopy should not be considered necessary…MY LIFESTYLE…MY VIEW…MY PERSONAL CHOICE
  23. Certain vegetables such as broccoli, cauliflower, garlic, onions, bok choy, brussel sprouts, turnips and leafy greens – causes the colon’s cells to secrete enzymes that inactivate many carcinogens. BTW, chlorinated water is also associated with a higher incidence of colon and rectal cancers…I choose to avoid chlorine
  24. The current 5 year survival rate (all stages) per conventional colon cancer treatment is approximately 61%. Most Americans believe this is closer to 100% based on medical propaganda and bias
  25. Jerome J. DeCosse, MD, PhD, and colleagues at the University of Wisconsin’s Department of Surgery and pathology discovered that when vitamin C was added to the treatment protocol of polyp sufferers, polyps were either reduced in number or completely eliminated in five out of eight people…I RECOMMEND AND TAKE VITAMIN C DAILY
  26. Scientific studies have indicated that high levels of vitamin D may reduce the risk of getting colon cancer by 51%. Therefore make sure regular exposure to sunlight before, 10:00 a.m. and after 3:00 p.m. is a part of you health regimen. Vitamin D supplementation is another excellent choice.
  27. Former presidential press secretary and media commentator Tony Snow died of complication due to colon cancer and medical intervention. Because Mr. Snow had a family history of colon cancer he had a colonoscopy exam at least every six months. Mr. Snow was told repeatable by his medical doctor that he did not have colon cancer. Unfortunately, the colon cancer that he went on to be diagnosed with existed for a number of years until it was finally discovered. Mr. Snow’s case should serve to illustrate that having colonoscopies does not guarantee or insure that one is free of cancer.
  28. Nearly two-thirds of hospitals fail to check colon cancer patients well enough for signs that their tumour is spreading, says a study of nearly 1,300 hospitals, and it was found that overall, just 38 per cent fully comply with the guideline, Northwestern University researchers report in the Journal of the National Cancer Institute. 9/10/08
  29. There is some humor to be had. Lou Rawls Colonoscopy Exam in English
  30. At-home stool test is just as effective for early colon cancer screening – but experts say you should not write off the colonoscopy

In closing, the core of my personal decision to not have a colonoscopy is, understanding risks versus benefits, living the way I live, and believing what I know to be truth. However, my personal views should not preclude any individual from having the right to choose to have any medical procedure including colonoscopy.

All my best,

Dr. Bob Martin