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Colorectal Cancer Screenings Now Recommended at Age 45

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Undergoing colorectal cancer (CRC) screenings starting at age 45 could be a new lease on life for millions of people in the United States.

The U.S. Preventive Services Task Force (USPSTF) on May 18 released its final recommendation to lower the colorectal screening age from 50 to 45, providing an opportunity for earlier detection and prevention of the disease. The USPSTF is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine.

“The incidence of colorectal cancer in 45-year-olds is the same as it was in 50-year-olds when the screening benefit for age 50 was implemented,” said John Popp Jr., MD, Medical Director for AMSURG. “Dropping the age to 45 may get those 50 and older screened earlier. We have found in our AMSURG data that the average age for initial screening is about 58.”

Increase in Cases

Colorectal cancer is the second most common cancer diagnosed in both men and women in the United States. The American Cancer Society (ACS) estimates 104,270 new cases of colon cancer and 45,230 new cases of rectal cancer will be diagnosed this year.

The number of colorectal cancer cases have been increasing since the mid-1980s in adults ages 20-39 and since the mid-1990s in adults ages 40-54, according to the ACS.

“In 2020, about 12% of all cases of CRC occurred in the under 50 year old population. Furthermore, patients diagnosed prior to age 50 were more likely to have advanced disease at diagnosis,” Popp noted.

The task force also recommends people ages 45 to 75 should undergo screenings, while individuals ages 76 to 85 should be screened based on the patient’s situation.

According to the USPSTF, “These recommendations apply to adults without symptoms and who do not have a personal history of colorectal polyps or a personal or family health history of genetic disorders that increase the risk of colorectal cancer.”

Screenings

Colorectal cancer is highly treatable when diagnosed in the early stages. For screenings, the task force recommends direct visualization tests (colonoscopy) and stool-based tests.

Individuals with any abnormal stool-based test result must follow up with a colonoscopy to see whether they have cancer or polyps which might become cancer.

Colorectal cancer is preventable through routine colonoscopy, the gold standard for colon screenings.

“The best screening test is the one that gets done, but colonoscopy is the only test that can prevent CRC by removing premalignant polyps,” Popp said.

The Affordable Care Act of 2010 requires both private insurers and Medicare to cover the costs of colorectal cancer screening tests because these tests are recommended by the USPSTF. To avoid any confusion, contact your health insurance agent or employer’s human resources department.

Early Diagnosis

Colorectal cancer is the second leading cause of cancer-related deaths. The disease is expected to cause about 52,980 deaths this year, according to the ACS.

Avoiding delays in diagnosis is important, Popp said, noting that there could be 40 percent fewer deaths if the stage at diagnosis could shift from stage 4 to stage 3.

An increase in screenings and improved treatments through the years has led to more than 1.5 million survivors of colorectal cancer in the United States, according to the ACS.

Individuals beginning screenings at age 45 will help doctors to diagnose more cases earlier and possibly prevent colorectal cancer in many patients.

AMSURG, a division of Envision Healthcare, is the national leader in providing colonoscopy. If you are age 45 or older, connect with a board-certified gastroenterologist at one of our screening centers.

More

AMSURG and Mount Sinai Health System Release New Research on Early-Onset Colorectal Cancer

AMSURG Reminds Americans to Seek Care in Fight Against Colorectal Cancer

Patient Safety a Top Priority Amid COVID-19 Pandemic

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COVID-19 has had far-reaching impacts on our lives, with medical procedures and surgeries deemed “elective” postponed in order to slow the virus’s spread. In reality, these procedures are far from optional: delaying medical interventions can result in increased health problems, such as later-stage cancer diagnoses.

Increased Patient Safety Measures to Combat COVID-19

In recent weeks, we have resumed elective cases and implemented a number of protocols to ensure your safety as you take charge of your health and schedule procedures at our ambulatory surgery centers. These measures include:

  • Screening everyone who enters the center for COVID-19 symptoms
  • Taking the temperature of every person who enters the center
  • Requiring masks for all employees and patients
  • Enforcing social distancing guidelines
  • Requesting patient escorts remain in the car until patient is ready to go home
  • Increasing cleaning of high-touch surfaces throughout the day
  • Providing hand sanitizer and tissues

Learn more about all of the steps we are taking to keep you safe.

Patients Feel Safe at our Centers

Patients who have already returned to the centers have first-hand experience of the new protocols in action. Their feedback has been extremely positive, with reactions like:

“During this COVID-19 time, I was especially nervous about my procedure but was immediately greeted by the friendliest nurse around. She was very courteous and kept asking if I was fine. She prepared me for the procedure by carefully doing everything that needed to be done and listened to me. The rest of the staff was also very professional and took great care of my needs. Thank you all for a great experience that I hopefully won’t have to repeat for a while.” – San Antonio, April 2020

“Even during these crazy times, I was treated with the utmost respect, courtesy, and care. My doctor and her amazing team took the necessary steps to make sure I wasn’t put at greater risk during my procedure. They ensured all my questions were answered, and I was 100% ready going into and out of the procedure.” – Escondido, April 2020

“Sanitary, safe, NICE and COMPASSIONATE staff!! Thank you SO MUCH to all of my nurses throughout the entire experience!” – Lakeside, AZ, May 2020

Safely Schedule a Procedure

With increased safety measures in place, there has never been a better time to schedule that colonoscopy; doing so could save your life! Stop putting it off and call your gastroenterologist today.

Doctors Can Lead by Example in Colon Cancer Screening

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Patients are more likely to choose colorectal cancer screening if their doctor has been screened already and discloses this information to them.

A doctor’s recommendation is compelling when it comes to preventive screenings like colorectal cancer screenings, especially when the physician leads by example. Screenings like colonoscopy exams are instrumental in helping people live longer and enjoy a better quality of life. Unfortunately, Americans are not getting all of the preventive care they should be receiving. Many Americans are not getting screened for colon cancer at the correct age or the proper interval, and some tests are inaccurate.

Colorectal cancer screenings performed at the correct age and frequency can reduce the risk of colon cancer death by up to fifty percent, according to data from the American Cancer Society. A new study published in Gastroenterology reports that doctors who follow through with their own colon cancer screenings are more likely to have patients who get screened.

When Physicians Get Screened, Patients Get Screened

Amit X. Garg, M.D., Ph.D., and fellow research colleagues at Western University in Canada wanted to find out whether there is a connection between colorectal cancer screening rates among physicians and their patients.

The researchers conducted a population-based study of patients in Ontario and found that the colonoscopy rate was 67.9 percent among physicians and 66.6 percent among patients. The research team found patients were more likely to comply with colonoscopy when their family doctors had themselves already had colonoscopy screenings.

The study suggests family doctors have significant influence in their patients’ decisions to get screened for colon cancer. If doctors disclose that they have already chosen colon cancer screening, their patients are likely to follow their example.

“Conversely, many physicians report difficulty counseling patients about behaviors they do not practice themselves,” the researchers stated in their report. “Given the clear benefits of colorectal cancer screening, programs that promote greater screening in physicians warrant consideration.”

Why Are We Neglecting Preventive Care?

The Centers for Disease Control estimates one out of three American adults is not being properly screened for colon cancer. Why are adults omitting a life-saving preventive test? Some patients may not be getting a colorectal cancer screening because:

  • They do not carry health insurance
  • They have limited contact with their primary care physician or do not have a primary care physician
  • Their primary care physician did not tell them to get screened
  • They lack the proper information on how to get screened

Screenings like colonoscopy can spare patients the physical, emotional and financial strain of a chronic, life-threatening disease. Also, many screening colonoscopies and other methods of colon cancer screenings are free through private insurance and Medicare.

When to Schedule a Colonoscopy Exam

Due to the increased incidence of young-onset colon cancer, the American Cancer Society suggests all adults at average risk for colon cancer begin screening at age 45. However, many insurance providers will not begin paying for screening until age 50. Talk to your doctor about when he or she began screening, and ask when you should schedule your first colonoscopy.

If you are not under the care of a fellowship-trained gastroenterologist, click here and enter your zip code in the orange box. We can connect you with a highly-skilled physician in your area who can provide quality gastrointestinal care. Our specialists are accepting new patients and are available for appointments.

Will Smith Has Polyp Removed During Colonoscopy

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Colonoscopies save lives every day, and actor Will Smith can attest to that.

Smith, who first gained fame as the Fresh Prince of Bel Air, decided to film his colonoscopy as a vlog for his fans. At the age of 51, he was due for a colonoscopy, but he planned to create the joke-filled video just for fun.

After he woke up from the procedure, he was shocked by what his gastroenterologist discovered. He had a precancerous polyp in his colon.

“You know, when I decided I wanted to shoot this as a vlog, it was much more, ‘Hey, this will be cool. This will be fun,’” Smith shared in an interview with Today.com. “I didn’t realize that there would be a precancerous polyp that would get found out of it.”

Colon Cancer Begins as a Precancerous Polyp

A few days later, Smith’s gastroenterologist called him and said the removed growth was a tubular adenoma containing precancerous cells. Almost all colon cancers initiate from this same type of polyp, but most cases can be prevented if all adults choose routine screening. Smith will likely need to get another colonoscopy in two to three years for monitoring. However, that is a small price to pay for colon cancer prevention.

As Smith reflected on his colonoscopy in his vlog, he tells his fans, “Everything feels normal. 2019, gotta get our health right. There’s a certain amount of commitment and embarrassment involved with being healthy. You just gotta do it, man.”

Guidelines for Colon Cancer Screening

The American Cancer Society’s guidelines for colon cancer screening suggest all adults at average risk for colon cancer begin colon cancer screening at age 45 instead of age 50, the age recommended by the U.S. Preventative Services Task Force. This new guideline was established in May 2018 after reviewing statistics that young onset colon cancer is on the rise in the United States. Earlier screening is important because colon cancer in young individuals tends to be aggressive and difficult to diagnose. Further, the American Cancer Society recommends African Americans get earlier screening due to an increased risk for colon cancer.

Consider these facts about colon cancer:

  • Only 66 percent of people who should be screened for a colonoscopy actually have been screened.
  • 25 percent of people age 50 and older have never been screened.
  • 80 percent of people diagnosed with colon cancer have no family history of the disease, and most show no symptoms.
  • 90 percent of colon cancers can be prevented with a colonoscopy.

Call Your Gastroenterologist

Certain risk factors may increase your risk for colon cancer, so talk to your doctor about when you should get your first colonoscopy. The next step is to call your insurance company. Many insurance plans begin coverage for colon cancer screening at age 50, so call your provider to get specific details about your plan.

If you are not under the care of a fellowship-trained gastroenterologist, click here to enter your zip code and find a specialist near you.

How to Make Colonoscopy Prep Drink, Process Tolerable

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You can choose to view a colonoscopy as a feared or dreaded task in your life — or as a milestone.

Growing older has its advantages. As you age, you accumulate knowledge and expertise, and your family begins to look to you as a source of wisdom. So, as you grow older, grow BOLDER. Use that boldness and wisdom to make choices that support your health and longevity.

One of the wisest decisions you can make is to schedule a colonoscopy to prevent colon cancer. Even though you might be dreading the colonoscopy prep, most people agree that it’s not that bad. Here are four ways to make preparation for your colonoscopy more tolerable:

Split the Dose of Colonoscopy Prep Drink

One of the longstanding complaints about the colonoscopy prep day is the large volume of liquid you must consume on the night before the exam. Recent studies confirm that this is no longer necessary. Drinking half of the solution the night before the exam and the other half on the morning of the exam is as effective as consuming the entire dose in one evening. Gastroenterologists refer to this new protocol as the split-dose method. Splitting the dose reduces feelings of bloating and nausea, which can lead to vomiting, and most patients affirm that the halved volume is much more manageable.

Flavor the Colonoscopy Prep Solution

Just like choosing your toothpaste flavor at a dental cleaning, you can customize the flavor of your prep solution. Select your favorite Gatorade or Crystal Light as the base of the solution and mix according to the colonoscopy prep instructions from your doctor. Most people find that chilling the solution in the refrigerator makes the drink much more palatable.

Jell-O, Gummy Bears and Other Creative “Clear Liquids”

A clear liquid diet may sound like a punishment, but you have more options than you might think. Did you know that chicken broth, soda, juice, popsicles, Italian ice, Jell-O, gummy bears and LifeSavers are considered “clear liquids”? You will definitely miss eating solid food on your prep day, but there is no reason to go hungry with so many available choices. Just remember to avoid beverages, frozen treats and candies that are orange, red or purple. Food dye can mask the lining of the colon and interfere with the colonoscopy.

It’s All Worth It

Even though you’ll be glad when the process is over, your prep day and colonoscopy procedure are major steps in preventing colon cancer, the third-leading cause of cancer death in the United States. Other colon screening methods are less invasive, but they don’t have any protective benefits. During a colonoscopy, your gastroenterologist can remove precancerous polyps before they become cancerous. Researchers agree that most non-hereditary colon cancer could be prevented if all adults were screened appropriately.

Get a Colonoscopy Earlier

As young-onset colon cancer incidence continues to increase, it is important to get screened earlier. The American Cancer Society recommends colon screenings beginning at the age of 45 (instead of 50) for all adults who are at average risk for colon cancer. If you are African American or you have a personal or family history of colon cancer or colon polyps, you should be screened before age 45. Talk to your doctor about your risk, when you should begin colon screenings and how often you should be screened. Remember that a colonoscopy will always be the best choice in colon cancer prevention.

Enjoy the Process of Growing Older

Instead of dreading the fact that you’re growing older, grow BOLDER! Commit to nutritious eating, daily exercise and routine screenings like colonoscopies for lifelong health. Your children, family and friends will be inspired by your example and want to follow in your footsteps.

Myth Vs. Fact: Time How Long Does It Take to Get a Colonoscopy?

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“I had to starve myself for days before my colonoscopy.”

“I had to take a week off work.”

“The procedure took all day.”

Let’s admit it. Everyone likes an embellished story. Exaggerations are part of what make stories so memorable and funny, except when it comes to colonoscopy stories. When colonoscopy prep and procedure details are stretched, exaggerated or inflated, it creates problematic colonoscopy myths. Because colon cancer is preventable with routine colonoscopies, it’s important to spread accurate information about colonoscopy prep and procedure time. Colonoscopy myths could make the difference in someone choosing a life-saving colonoscopy or avoiding the procedure because of fear.

Let’s examine each colonoscopy myth and apply some truth:

“I had to starve myself for days before my colonoscopy.”

Most gastroenterologists still advise patients to follow a liquid diet on the day before their colonoscopy, but there is no need to starve! You can drink clear liquids such as soda, tea, juices, lemonade, flavored water, coffee (without cream) or broth. You can also have popsicles, Jell-O, Italian ice or anything that dissolves into a clear liquid. Just make sure to avoid anything purple or red. Your fast will last one full day. After your procedure, you can eat as you please.

“I had to take a week off work.”

Nope. That is just not true. You will have to take one day off work, and that is the day of your procedure. You can still go to work on your fast day because you will not be consuming the preparation laxative until that evening. After your procedure, you’ll need a caregiver to drive you home so you can rest. You can go to work the following morning.

“The procedure took all day.”

Plan on 2 to 3 hours from check-in to discharge. Be assured that your GI surgery center will not keep you longer than needed and will send you home as soon as possible.

Find a Gastroenterologist to Schedule a Colonoscopy

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A colonoscopy is your most powerful defense against colon cancer. It is the most comprehensive colon screening test available because it allows your doctor to examine colon for polyps, ulcers, tumors or lesions. If polyps or abnormalities are found during the examination, your doctor can remove them immediately.

It is estimated that between 60 and 90 percent of cancer deaths could be avoided if all Americans over the age of 50 got a colonoscopy. Most cancer screenings only detect the presence of cancer, but colonoscopies actually prevent you from getting colon cancer by removing precancerous polyps. For this reason, the colonoscopy is considered the gold standard for colon screening.

Most adults who are at average risk for colon cancer are eligible for a colonoscopy at age 50. Maybe you are eligible for a colonoscopy this year, but you have some uncertainties about the exam. You may not know how to go about scheduling a colonoscopy or who to call. There is no need to worry, though. Sometimes, you just need a step in the right direction.

Stop Colon Cancer Now partners with physicians and surgery centers nationwide, and they are available to answer your questions. Each of our gastroenterologists are board-certified, and all of our centers are accredited. This means you can rest assured that you’ll receive a quality colonoscopy from a professional, compassionate medical team.

We have created a simple Find a Center tab that will connect you to a licensed gastroenterologist and accredited center in just a few clicks of the mouse. Click on your state, and you will have immediate access to our partner centers in your area. There is even a Schedule an Appointment button where you can enter your information and you don’t even need to pick up the phone.

Take a stand against colon cancer during Colon Cancer Awareness Month. When you schedule a colonoscopy, you are making a commitment to lifelong colon health and overall wellness!

What is the Best Diet in Preparation for My Colonoscopy?

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Compared to other preventative screenings, colonoscopies require extra time and preparation. Think about it: you don’t have to do anything to prepare for a vision screening, mammogram or prostate cancer screening. You simply show up for your appointment and no preparation is required. Colonoscopies are unique because you must completely empty the bowel to give your doctor a clear view of your colon. A clean colon gives your doctor the best opportunity to find and remove precancerous polyps.

Modify your diet a few days before the colonoscopy

Colonoscopy preparation actually begins several days before the procedure. Everyone is familiar with the clear liquid diet on the day before the colonoscopy, but your doctor may suggest a low-fiber diet about three to five days before your colonoscopy. It includes dairy, refined carbohydrates, fats, lean meats, and fruits and vegetables without peels. Eliminating high-fiber foods a few days prior will minimize the production of waste, make the purgative process easier and result in a higher quality colonoscopy.

Here are some examples of foods that you can eat on the days leading up to your colonoscopy:

  • Milk, cheese, yogurt, sour cream
  • White rice, white bread, refined pasta, refined crackers, breakfast cereals
  • Applesauce, canned vegetables, fruits without seeds or skin
  • Chicken, pork, seafood
  • Salad dressing, butter, ice cream, pudding

Your doctor will give you a comprehensive list of permissible foods at your consultation appointment.

Consume clear liquids on the day before the colonoscopy

On the day before the colonoscopy, you will be drinking the purgative colonoscopy preparation solution to clear your bowel. You can also consume clear liquids that day such as juices, soft drinks, black coffee, plain tea, strained broths, and Jell-O and popsicles (no red or purple).  On the day of your procedure, your doctor may restrict you to water only.

Diet modifications are only temporary

No one looks forward to colonoscopy preparation, but try to remind yourself that it is only for a short time. You may actually find yourself looking forward to abandoning your high-fiber/low-fat diet for a few days and indulging in some creamy desserts and your favorite childhood breakfast cereal. Don’t get too comfortable, though. You’ll need to go back to whole grains, fresh fruits and vegetables and limited fats after your colonoscopy, but you might as well enjoy a few extra treats while you can!

What is the Difference Between Screening and Diagnostic Colonoscopy?

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Before you have your colonoscopy, it is important to call your insurance company about your benefits. There are two types of colonoscopies: screening and diagnostic. Most insurance companies will cover screening colonoscopies, but most diagnostic colonoscopies will be subject to deductibles and co-insurance.

Insurance providers have very specific criteria for both types of colonoscopies, so it is advantageous for you to call Member Services to inquire about your benefits and out-of-pocket estimates for your screening or diagnostic colonoscopy. Here are some factors that influence whether your procedure will be billed to your insurance company as a screening colonoscopy or a diagnostic colonoscopy:

Screening Colonoscopy Criteria:

  • No family history of colon cancer or colon polyps (some insurance providers consider this high risk for colon cancer)
  • No personal history of colon cancer or polyps
  • No symptoms before the procedure (abdominal cramping, blood in the stool, weight loss, anemia, vomiting)

Diagnostic Colonoscopy Criteria

  • Family history of colon cancer or polyps (some insurance providers consider this high risk for colon cancer)
  • Personal history of colon cancer or polyps
  • Symptoms are present before the procedure (abdominal cramping, blood in the stool, weight loss, anemia, vomiting)
  • Previous colonoscopy(ies) had findings of polyps, colon cancer, diverticulitis, etc)

When you are on the phone with your insurance company, you should also verify that your preferred gastroenterologist and facility are both in-network to keep the cost down. It is important to remember that these are just guidelines, and benefits may vary. Get the facts before you go in for your colonoscopy. Asking the right questions will help you be prepared and confident on the day of your procedure. Make sure to read our article, Questions to Ask Your Insurance Provider to Determine Your Colonoscopy Cost.

Adenoma Detection Rate Coincides with Colonoscopy Prep

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Good colon health is a two-way street that requires a committed partnership between you and your gastroenterologist. A patient’s responsibility prior to a colonoscopy is to thoroughly empty the bowel to create maximum visibility for the GI doctor to view any abnormalities in the colon. The doctor’s responsibility is to carefully examine the entire length of the colon and remove lesions or colon polyps that could become cancerous.

Dr. Paul Brown of Louisville Endoscopy Center has performed thousands of colonoscopies. Dr. Brown is the Medical Director of Louisville Gastroenterology Associates, specializing in internal medicine and gastroenterology. Dr. Brown explains the patient-physician partnership that is required to achieve a quality colonoscopy.

Of all the possible methods to screen the colon for colon cancer, why is a colonoscopy the preferred method?

A colonoscopy is considered the gold standard for colon cancer screening because it prevents colon cancer through the detection and removal of precancerous adenomatous polyps. This procedure allows the gastroenterologist to view the entire length of the colon to evaluate the health of your digestive tract.

The gastroenterologist inserts a long, flexible tube called a colonoscope  into the rectum with a camera attached to detect abnormalities. If any colon polyps are discovered during the procedure, the doctor can remove the adenomatous polyps during the colonoscopy, thus preventing colon cancer before it starts. No other colon cancer screening can provide this. Therefore, I tell my patients that a colonoscopy can be both a diagnostic and a therapeutic procedure.

What is Adenoma Detection Rate (ADR) and why is it important?

Adenoma Detection Rate (ADR) is the percentage of time that at least one adenomatous polyp is detected during a physician’s screening colonoscopies. The national average is 25 percent for men and 15 percent for women; our percentages at our surgery centers are much higher and range between 25 and 50 percent. Knowing a physician’s Adenoma Detection Rate is an important qualifying factor in selecting the GI specialist, which will give the patient added confidence when committing to the procedure.

Adenoma Detection Rate is a helpful tool because it is a direct measure of the effectiveness of the colonoscopy that a gastroenterologist offers. As patients interview potential physicians to perform their colonoscopy, they should remember that the higher the ADR, the lower the colon cancer risk.

How does a High Adenoma Detection Rate Relate to a Quality Colonoscopy?

A high Adenoma Detection Rate is essential for a quality colonoscopy and for colon cancer prevention. For every 1 percent increase in a physician’s ADR, the risk of a person developing colon cancer over the next year decreases 3 percent. Doctors who are effective in detecting and removing precancerous polyps have a high ADR and their patients are less likely to develop cancer.

Are there are any other criteria that patients should use to qualify a gastroenterologist?

Patients should ask physicians about their average withdrawal time during a colonoscopy. This refers to how quickly the colonoscope is removed from the colon once the scope reaches the cecum, the farthest point in the colon. The minimum time should be six minutes, so a withdrawal time greater than six minutes is associated with a higher ADR.

Another qualifying measure is known as cecal intubation rate, which refers to how often a physician sees the entire colon. The colonoscope should be advanced all the way to the cecum to allow visualization of the entire colon. A physician’s cecal intubation rate should be greater than 95 percent for screening colonoscopies.

Does it matter what type of bowel prep kit a patient uses?

The gastroenterologist will help choose the best bowel preparation for each patient based on their age, medical history and medications. Most importantly, patients must follow the directions exactly as they are written. A thorough colon cleanse is an essential part of the colonoscopy. The colon must be free from debris and waste so the GI speicalist can detect lesions, colon polyps and abnormalities.

How has Colonoscopy Prep Changed Over the Years to Make it More Tolerable?

Much has changed regarding bowel preparation methods in the past decade. In the past, most doctors prescribed single-dose products such as Trilyte, Nulyte or Golytely. These bowel preparations were effective, but they had many disadvantages, the first being that patients had to consume 4 liters of liquid over a short period of time. This left patients feeling bloated, full and nauseous, and vomiting was common. If patients were not able to finish all of the purgative solution, their bowel preparation was often incomplete and exam results were inconclusive or compromised.

The split-dose method splits the purgative dose into two parts: The first half of the dose is taken in the evening, and the second half is taken very early in the morning (to allow for at least two hours of fasting before anesthesia). Almost all patients prefer the split-dose method because the volume of liquid is much more tolerable, and they do not have the symptoms of nausea, bloating and abdominal fullness that the single-dose method often causes.

Which Colonoscopy Prep method do you Prescribe to your Patients and why?

For the past three to four years, I have routinely prescribed Suprep and Moviprep using the split-dose method. I find that splitting the dose cleans the bowel more effectively, and I liken it to sending a car through the car wash twice instead of just once. The colon is more thoroughly flushed, which provides an optimum environment to detect precancerous polyps.

The split-dose method allows for better visualization of the colon, especially the right side where adenomatous polyps are often missed due to poor colonoscopy prep. The split dose method just results in a cleaner colon, which increases the Adenoma Detection Rate. This, in turn, increases polyp removal and decreases colon cancer incidence.

Are there any disadvantages of the split-dose method?

Most patients want to schedule a colonoscopy during the morning hours, so yes, they may see it as a disadvantage to wake up very early on the morning of their procedure to take the second dose of the bowel prep solution. However, this is where I have the opportunity to educate my patients. I remind them that, in order to achieve an optimal bowel prep, this will allow me to be successful in finding and removing all colon polyps. This sacrifice on their part is necessary. Most patients like to do their part in providing a well-prepped colon, so they are quite agreeable to wake up early when I give them this explanation.

Besides the prep, what are some other reasons why people don’t get a colonoscopy?

There are probably three major reasons why people do not schedule screening colonoscopies:

Fear of unknown. People may rather ignore the idea of getting a colonoscopy if they don’t understand what it is or why they need it.

People think a colonoscopy will be painful. When primary care physicians refer patients to a gastroenterologist for a colonoscopy, they can offer the reassurance that anesthesia makes the procedure painless. In fact, the vast majority of patients will not even remember the procedure.

People think that they will miss too much work. Because most people will take the first dose of purgative the night before the colonoscopy and take the second dose the morning of the procedure, they will only have to miss one day of work.

Colonoscopies are not scary, painful or a waste of time. They offer colon cancer detection as well as colon cancer prevention. Therefore, we can say that colonoscopies are both diagnostic and therapeutic. As primary care physicians educate their patients on the life-saving benefits of preventative colorectal screening, we will continue to see colon cancer incidence decrease.

Dr. Brown attended medical school at the University of Louisville, where he was Chief Medical Resident. He completed a fellowship in Gastroenterology at the University of Louisville and has dedicated his career to serving the Louisville community in the field of gastroenterology.

Among his many achievements, Dr. Brown has authored several articles relating to gastroenterology and has been voted “Top Doc” by his peers in eight successive surveys in Louisville Magazine. To learn more about Dr. Paul E. Brown and his gastroenterology practice, please visit louisvillegastroenterology.com.