by Amit Khanna

Only about half of Americans age 50 or older are up to date with colorectal cancer screening. If everyone were tested as recommended, thousands of lives could be saved each year. Regular colorectal cancer testing is one of the most powerful weapons for preventing colorectal cancer or finding it early, when it’s easier to treat.

Why is colorectal screening so important?

Colonoscopy finds both colorectal polyps and cancer. Removing polyps can help prevent colorectal cancer from ever starting. And cancers found in an early stage, while they are small and before they have spread, are more easily treated. Nine out of 10 people whose colon cancer is discovered early will be living five years later; and many will live a normal life span.

Without early detection, the cancer can grow and spread without being noticed. Early on, colorectal cancer doesn’t usually cause any changes that are noticed. In most cases, by the time people do have symptoms the cancer is advanced and very hard to treat.

Regular screening is the most reliable way to find cancers in the early stages.

What happens in a screening?

Colonoscopy is an exam that lets a doctor closely look at the inside of the entire colon and rectum for polyps or signs of cancer. Polyps are small growths that over time can become cancer. The doctor uses a thin, flexible, hollow, lighted tube that has a tiny video camera on the end that sends pictures to a TV screen.

The exam itself takes about 30 minutes. Patients are usually given medicine to help them relax and sleep while it’s performed.

Your doctor decides how often you need this test, usually once every 10 years, depending on your estimated risk for colon cancer. It’s important for you to talk with your doctor to understand your risk for colon cancer, the guidelines you should follow for testing, and whether you need to start having the tests at age 50 or earlier.

How do I prepare? Will I need to miss work?

Preparing for colonoscopy makes you to go the bathroom a lot! You usually start your preparation a day or two before the actual test. Because colonoscopy is usually done with drugs that make you sleepy, most people miss work the day of the test.

Most people feel okay after a colonoscopy, however, because often patients are a bit woozy from the anesthesia, you’ll need a ride home.

What if they find something?

If a small polyp is found, your doctor will probably remove it during the test. Over time some polyps could become cancer. If your doctor sees a large polyp, a tumor, or anything else abnormal, a biopsy will be done. For the biopsy, part or all of the polyp or abnormal area is taken out. It’s sent to a lab for a doctor to look at under a microscope and check for cancer or pre-cancer cells.

Hopefully, the significance of screening is evident. Too often, false information and a misplaced sense of modesty scare people away from this potentially life-saving test. Join me at the free summer concert series at Pastorius Park at 7 p.m. Wednesday, July 2, where I’ll be available to answer any of your questions about colorectal care.

Amit Khanna, M.D., is a colorectal surgeon at Chestnut Hill Hospital.