Colonoscopy - Screening, Diagnosis, and Surveillance for Colon Cancer

The idea of a colonoscopy is ... unappealing.

Here we demystify some of the common questions about colonoscopy and the three (3) main purposes of the procedure: Screening, Diagnosis and Surveillance.

Read the full video transcript below:

Nobody particularly wants to have a colonoscopy, mostly because the prep is unpleasant and the general idea of the procedure is rather unappealing. But the truth is, you won't remember much about the procedure itself. 

During the procedure, a camera on the end of a long coiled tube goes up the rectum and then curls around the entire length of the colon. On its way out, the entire surface of the colon and rectum can be examined to look for potentially harmful problems. 

There are three main reasons to get a colonoscopy: screening, diagnosis, and surveillance. 

Screening colonoscopies are the most common type, and they are performed on patients who have no symptoms whatsoever. Screening for colon cancer with colonoscopy has been shown to prevent colon cancer deaths. The current recommendation is to start screening for colon cancer with colonoscopy at age 45. Usually screening happens every 10 years, however, sometimes it’s more frequent if colonoscopies in the past showed suspicious findings like polyps. 

If polyps are found, they can be removed. A pathologist reviews the material under a microscope and can tell us whether that was a benign problem or something more concerning like a cancerous or precancerous lesion. 

The second type of colonoscopy is a diagnostic colonoscopy. This is generally done for patients who have either anemia or bleeding or cramping or chronic diarrhea that can't be explained by an infection. If symptoms are significant enough, diagnostic colonoscopy can be done at any age. If a suspicious lesion or a tumor is encountered at the time of colonoscopy, a biopsy can be obtained. 

Diagnostic colonoscopy can also be helpful for non-cancerous lesions like ulcerative colitis or Crohn's disease. These areas can be biopsied and evaluated under a microscope to determine the pathologic diagnosis.

After a diagnosis is made, the next steps in management include potential treatments like surgery, chemotherapy, radiation, or other medical treatments for non-cancerous lesions, can be started. 

The third type of colonoscopy is a surveillance colonoscopy. This is generally done after treatment to assess the response. Surveillance colonoscopies can either be routine or prompted by new symptoms. 

This is not medical advice. Talk to your doctor before making any medical decisions.