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Colonoscopy: The Screening Gold Standard

A colonoscopy lets doctors see inside the large intestine, which includes the rectum and colon. Physicians insert a lighted tube with an attached camera into the rectum to view parts of the digestive system. One benefit of the procedure is that it allows the doctors to identify any problems and remove precancerous polyps at the same time.

The American Cancer Society recommends a colonoscopy every 10 years for people with an average risk of colorectal cancer. You may need to undergo screening at a younger age and more often if you have more risk factors, such as a family history or a genetic mutation that puts you at higher risk.

Colonoscopy Controversy?

Recently, research triggered a controversy over colonoscopy exams.

A large study published in The New England Journal of Medicine sparked some controversy over the benefits of colonoscopy screening. The results showed that people who were invited to be screened for a colonoscopy and those in a usual care group had nearly the same death rates 10 years later.

A key piece of information explains the findings: Only 42 percent of the participants who were invited to have a colonoscopy actually had the exam.

“The other patients, who did not accept, were not screened,” explains Douglas A. Corley, MD, PhD, a research scientist at the Kaiser Permanente Northern California Division of Research in Oakland, California. “This study only allowed an evaluation of how effective a program for inviting people to colonoscopy might be. It did not directly evaluate the effectiveness of colonoscopy.”

When the study researchers analyzed only those who had the screening, they found colonoscopies reduced the risk of death from colorectal cancer by about 50 percent.

“Preventive cancer screenings, including colonoscopy, are the best and most trusted way to save lives,” commented the American Cancer Society, in response to the study.

“That’s why the American Cancer Society recommends colorectal screening, including colonoscopy, for adults beginning at age 45. There’s no reason to change that direction. Recommended cancer screenings should be a routine part of good health,” the society wrote.

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