Anyone who has experienced colonoscopy considers it a sort of necessary evil. While realizing the importance of ensuring that our colon is healthy and functioning normally, the prospect of undergoing an uncomfortable procedure involving a private area of our body is less than appealing. As a result, many put off this important exam.
Facts
Colonoscopy is a procedure where a long, thin, flexible instrument with a camera at the tip is used to examine your entire colon, also known as your large intestine. It enables the doctor to look for any irregularities, and allows him to take samples of any tissue he feels may be of concern. To date, it is much more reliable than any other of the standard screening methods, although it is the most invasive.
Advances
Another screening method that is finally coming of age is a technique called virtual colonoscopy, also known as CT colonography. Specialized CT scan techniques are used to produce multiple images of the abdomen and pelvis. Sophisticated computers then assemble these images into detailed three-dimensional pictures of the colon and rectum that can show polyps (small, protruding masses of tissue) and other abnormalities.
Comparisons
Colonography is less invasive than traditional colonoscopy, which makes the procedure more comfortable for the patient. In both cases, however, the colon must first be cleansed using a liquid laxative the day before, and eating is restricted. Colonoscopy also requires the patient to be sedated, and there is a slight risk of instrument-related complications such as bleeding or tearing of the colon.
A study performed by University of Munich's Frank Kolligs, MD, and presented at the annual Gastrointestinal Cancers Symposium, demonstrated that both Colonoscopy and Colonography detected pre-cancerous growth and polyps larger than 10 millimeters--a size considered dangerous--at basically the same rate. Colonoscopy did find more smaller polyps--5 millimeters or less--but these rarely become cancerous.
Considerations
Because both methods produce very similar results, and given that colonography seems to be much more patient-friendly than colonoscopy from a comfort and modesty standpoint, the obvious choice would be colonography, right? Not so fast. One advantage of colonoscopy is that if an abnormality is detected, it can be removed immediately and sent for tests. In addition, because colonography is relatively new and not yet widely used, not all insurance companies currently cover the costs of the exam.
Conclusion
Based on available evidence, both exams are viable options for detecting cancer. To ensure a higher success rate for each type of procedure, it is important to closely follow pre-exam preparation instructions, as well as guidelines for how often you should be screened. To help you make a more informed decision, it is important to discuss both colonoscopy and colonography with your doctor and address any concerns or questions you may have. Find out whether there are facilities in your area that specialize in colonographies and exactly what procedures are covered by your insurance policy.
Bottom line--regardless of which colon cancer screening procedure you decide upon, the most important thing is to put aside any trepidation, make an appointment with your doctor, and get the screening done. Your family will thank you.
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