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Colonoscopy Still ‘Gold Standard’ For Preventing Colon Cancer, Johns Hopkins Expert Says - 03/02/2011

Colonoscopy Still ‘Gold Standard’ For Preventing Colon Cancer, Johns Hopkins Expert Says

Release Date: March 2, 2011

A colon cancer expert at Johns Hopkins says that a colonoscopy remains underused by Americans but remains the test of choice for preventing the number-two cancer killer overall.

Suggestions have emerged recently from several studies that sigmoidoscopy, which uses a flexible scope to examine only the lower portion of the bowel, or other tests may be just as useful as colonoscopy to detect and treat colon cancer early in some people.

But Anthony Kalloo, M.D., professor of medicine and the director of the Division of Gastroenterology and Hepatology, says that more than 90 percent of colon cancers start as polyps and that the great advantage of a colonoscopy over other testing methods, such as fecal blood test, sigmoidoscopy or barium enema, is that it makes it possible to remove a suspect polyp or cancer immediately.

More than 4 million Americans annually have colonoscopies hoping to avoid colon cancer, but according to the American Cancer Society (ACS), as many as 40,000 of 55,000 annual deaths from the disease would be prevented with the use of colonoscopy or other tests.

With the start of National Colorectal Cancer Month, medical professionals at the Johns Hopkins School of Medicine’s Division of Gastroenterology and Hepatology are strongly urging all men and women over the age of 50 to have a colonoscopy. Studies have also shown that men and women of African-American or Eastern European/Jewish descent are more likely to develop the disease than those of any other racial or ethnic groups.

A colonoscopy, which uses a thin, flexible tube with a light and camera attached to examine the lining of the large intestine, is one of the most highly recommended medical tests today and possibly one of the least understood. The procedure can be used to help diagnose abnormalities such as ulcer polyps, tumors and areas of inflammation or bleeding as well as screen for cancer. The colonoscopy itself takes about half an hour and is performed under intravenous sedation.

Some are hesitant to undergo a colonoscopy because of embarrassment or stories about how unpleasant the preparation — total cleansing of the bowel with laxatives and enemas — is. 

But according to 2010 studies, which looked at colonoscopy patient outcomes from the Accreditation Association for Ambulatory Health Care (AAAHC) Institute for Quality Improvement, 71 percent reported little or no discomfort during the pre-procedure bowel preparation and 96 percent reported little or no discomfort during the procedure. 

“In most cases, the preparation has been considerably simplified. The current trend is toward deeper sedation and, with improving technology, the test can be performed quickly with fewer complications,” says Kalloo.

Kalloo says Johns Hopkins established a policy six years ago that sedation withdrawal times should not be shorter than eight minutes and that an average time for colonoscopy at Johns Hopkins is about 20 minutes with favorable detection and low complication rates.

“People shouldn’t be afraid. The days of discomfort, doubt and danger often associated with a colonoscopy are long gone.  And, most importantly, it saves lives,” adds Kalloo. 

Johns Hopkins School of Medicine’s Division of Gastroenterology and Hepatology

American Cancer Society

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