Congratulations, you did it! Yes, you went ahead and got that dreaded colonoscopy.
You found a qualified and experienced doctor and had it done. That alone puts you ahead of the nearly 42 million people 50 years of age or older at average risk of colorectal cancer who skipped this critical test. After all, it’s better to experience the relatively minor discomforts of a screening test that significantly reduces your risk of colorectal cancer, the third leading killer of both men and women.
Sure, you were nervous about the real (and imagined) problems of the test. But now you are looking at the results of your test and wondering what they mean. Here are answers to some commonly asked questions, thanks to Marianne Ritchie, MD, a gastroenterologist at Jefferson.
What does it mean if polyps are found in your colon?
Colon polyps are common. If a polyp is found, Dr. Ritchie explains, it will be removed during the exam and sent to the lab to see if it contains cancer cells. Most polyps are benign (do not contain cancer), but virtually all colon cancer begins as a polyp. “That’s why finding and removing polyps early is an effective way to prevent colon cancer,” she reiterates.
There are two types of benign polyps that are related to colon cancer:
- Hyperplastic polyps are usually very small and were formerly thought to not increase the risk of cancer. “Now there is evidence to show there is an increased risk of cancer if a patient has more than 30 hyperplastic polyps at the initial exam,” Dr. Ritchie reveals.
- If the polyps found are adenomas, there is an associated risk of colon cancer and you will need to be screened at least every 5 years because you are at risk of forming new polyps.
The size and number of polyps matter, too. “The risk of developing colon cancer is increased by the size and number of polyps found at the initial exam and following exams,” Dr. Ritchie states. “If a polyp is larger than 1 centimeter, there is a greater risk that it contains cancer cells.”
At what age should colonoscopy begin?
Screening guidelines recommend that age 50 is the time to begin routine screening to look for early signs of colon cancer, assuming you have no other risk factors. However, Dr. Ritchie points out that you may want to be screened earlier if you have one of the following risk categories:
- You have a first-degree (parent, sibling, child) relative who has had colon polyps or colon cancer. The formula determining the first screening exam considers the age when the affected relative was diagnosed. For example, if a parent is diagnosed at age 50, then screening should begin when the patient is 10 years younger. Here, the new patient would begin routine screening at age 40.
- A personal history of colon polyps or colon cancer
- A personal history of inflammatory bowel disease including Crohn’s disease or ulcerative colitis
- A personal history of uterine or ovarian cancer before the age of 50
How often should it be repeated?
Your initial exam will tell you how often a colonoscopy needs to be repeated.
- If you have no polyps and no family history or other risk factors listed above, you are often instructed to return in 10 years.
- If you have no polyps or cancer, but you do have a family history of colon polyps or cancer, you will likely be asked to return for a colonoscopy every five years.
- If colon polyps are found during the exam, you will be asked to return at a time interval depending on how many polyps are found, how large they are and the pathology report, Dr. Ritchie explains. If multiple polyps are found, the exam may have to be repeated in three years. If a very large polyp is found, a colonoscopy may even be repeated within one year to ensure that all the polyp tissue was removed.
Most importantly, Dr. Ritchie stresses that you should call your doctor and return immediately if you develop new symptoms or signs such as rectal bleeding, change in bowel habits or abdominal pain. In addition, you may also need to repeat a colonoscopy sooner if a new diagnosis of colon polyps or colon cancer is made in a family member.
To make an appointment for a colonoscopy, please call 1-800-JEFF-NOW.