Colonoscopy: Who Needs It, How It's Done And How It Can Save Your Life

In Germany, the introduction of colonoscopy has started bearing fruit. Within a decade of initiating the screening for colorectal cancer, the rate of new cases has substantially dropped among those with ages 55 and above, reports a new study.

Published in the journal Deutsches Ärzteblatt International, the findings from the German Cancer Research Center showed that after decades of steady increase, the incidence of colorectal cancer in the age group dipped by 13.8 percent among men and 14.3 percent among women, while deaths dropped by 20.8 percent among men and 26.5 percent among women.

Colonoscopy for Germans aged 55 and older was added to the national cancer screening program of the country in October 2002.

But what is this screening procedure and how does it help save lives?

How Colonoscopy Is Done

Colonoscopy is a test allowing doctors to view the inner lining of the large intestine, which comprises of the rectum and colon. This procedure, which uses a thin and flexible tube to look at the colon, can detect any ulcer, colon polyp, tumor, and areas of bleeding or inflammation, as well as check for pre-cancerous growths or actual cancer.

It is among the many tests used for detecting colon cancer, alongside stool tests, sigmoidoscopy, and computer tomographic colonography.

After cleaning out the colon — including following a liquid diet days before — colonoscopy, which usually takes up to 45 minutes, will be performed this way:

1. The patient will lie on the left side with knees pulled up to the belly. Medication will be administered.

2. The doctor will insert a colonoscope in the patient's anus and move it slowly through the rectum and into the colon. The colon will be inflated with air to enable the doctor to view the organ lining through the scope or on a computer screen.

3. The patient may feel some cramping or even an urge to have a bowel movement. The belly muscles can be relaxed by breathing deeply and slowly through the mouth.

4. The doctor will look at the colon's whole length as the scope gently moves in and then out of the organ. Tissue samples may also be collected and growths may have to be taken out using tiny tools such as forceps.

5. Once the scope is pulled out of the anus, the anal area will be cleaned using tissue.

Target Groups And Benefits

Groups such as the American Cancer Society and the U.S. Preventive Services Task Force recommend colonoscopy as routine testing for individuals ages 50 and above who maintain a normal colorectal cancer risk. Doctors, however, may recommend more frequent or earlier testing with a higher risk.

A doctor who finds a small polyp will likely remove it during the colonoscopy itself, and this is deemed a powerful way to help prevent colorectal cancer from even starting. Early-stage cancer detection, too, spell great ease and effectiveness of treatment.

"Most people whose colon cancer is found and treated early will be alive five years later. And many will live a normal life span," says the ACS.

In this procedure, some normal findings include a smooth and pink lining of the colon, normal folds, and no growths and bleeding present. Some abnormal findings, however, include hemorrhoids, polyps and sores, pouches in the organ wall called diverticulosis, and inflammation.

Colonoscopy is more expensive than a stool test or other colon tests, but experts agree that it can be conducted less frequently over time when there are normal results. The doctor decides how often the test should be done, typically once every five years depending on the risks present.

It is highly advised to discuss with a health care provider which screening test is best and what risks are present, as well as one's preferences for the procedure.

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