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The Colonoscopy: A Lifesaving Procedure That Gets a Bad Rap

Doctor talking to a senior patient about a colonoscopy as both wear masks

When it comes to detecting and preventing colorectal cancer, the colonoscopy is the gold standard: it’s the most effective tool we have to catch colorectal cancer early, when it’s most treatable. In addition, if a precancerous growth is found during the procedure, it can be removed on the spot.

This is encouraging news because according to the American Cancer Society, colorectal cancer is the third leading cause of cancer death in both men and women. So, how do we reduce colorectal cancer deaths? Get more people screened.

March is colorectal cancer awareness month, so it’s a good time to learn about this potentially deadly disease and spread the word about the colonoscopy, the most effective way to screen for colorectal cancer.

Is a Colonoscopy as Bad as It Sounds?

When it comes to a colonoscopy, people tend to think of the negatives. For example, you’ve probably heard a lot about the preparation that precedes a colonoscopy: No solid food the day before, drinking a laxative…and you can probably guess what happens next.

While the prep isn’t the first thing you’d choose to do on a day off, it’s necessary to ensure that your doctor is able to recognize abnormalities in your large intestine during the screening. These may include ulcers, colon polyps, tumors, and areas of inflammation or bleeding.

The procedure itself takes less than an hour, during which time you’re under light sedation (i.e., you’ll be asleep for the entire procedure). A doctor will use a colonoscope (a flexible tube with a light and a camera) to examine the length of your colon. When the procedure is done, you’ll wake up hungry and ready to head home…of course you’ll need to arrange for a ride home in advance.

No matter what, the benefits of a colonoscopy far outweigh the temporary inconvenience: Not only is a colonoscopy the most effective tool to catch colorectal cancer early, preventing complications and even death, but if a precancerous growth is found, it can be removed then and there.

“No One Ever Died of Embarrassment”

As a physician who knows the benefits of early detection, it’s sometimes easy to forget that many patients are intimidated by the idea of getting a colonoscopy. In fact, one in three eligible adults put it off. Why? Well, as we know, it’s certainly not as easy as getting an X-ray. But perhaps the biggest barrier is obvious: embarrassment.

It’s natural for people to feel hesitant about undergoing a somewhat invasive screening like a colonoscopy, but it’s critical that they overcome their reluctance. To me, it boils down to an advertisement a gastroenterologist ran in my local newspaper: “No one ever died of embarrassment.”

There may also be other barriers to getting a colonoscopy, such as fear (of potential results) or time. Sometimes people are so busy, they don’t prioritize getting one.

Other less-invasive colorectal cancer screening options exist, such as sigmoidoscopy and take-home kits that test for hidden blood in the stool (one popular kit is the FIT test). These are valuable screenings too, but, it’s important to keep things in perspective: A colonoscopy is a temporary inconvenience, like getting an oil change or visiting the dentist. But once you get a colonoscopy, you won’t need to get another one for ten years if everything is normal and you are of average risk. In contrast, a take-home test such as FIT has to be repeated every year.

Getting More People Screened

Nothing underscores the importance of colonoscopies and preventive screenings more than our commitment to encouraging our members to adhere to colonoscopy recommendations. That’s why we offer paid time off for our associates to get preventive screenings. Independence members can sign up to receive text or email alerts reminding them when this and other important screenings are due.

In addition, our providers are given lists of members eligible for screening. The providers have the option to offer these members annual fecal immunochemical tests (FIT) to take home. In addition, the Quality Incentive Payment System (QIPS) program pays primary care providers to close gaps in colorectal cancer screenings.

When to Get a Colonoscopy

So, when should you get started? The U.S. Preventive Services Task Force updated its guidelines in May 2021 to align with those of the American Cancer Society and now recommends regular colorectal cancer screening for adults age 45 to 75. If you’re an Independence Blue Cross member, you have $0 cost-sharing for colorectal cancer screening so talk to your doctor about getting screened.

There are certain factors — including family history, conditions such as inflammatory bowel disease, diabetes, and race/ethnicity — that may put you at an increased risk for colorectal cancer.

People who are at a higher risk for colorectal cancer — such as Black people (who are diagnosed at higher rates) and those who have a family history of colon or rectal cancer — may need to get screened at an earlier age. So, talk to your doctor about your risks, and if you’d be a candidate for earlier screening (especially if you have any of the risk factors mentioned above)

Dr. Victor Caraballo, MD

Dr. Caraballo is Vice President of Quality Management for Independence Blue Cross. In his role, Dr. Caraballo is responsible for all activities associated with ensuring health plan compliance with the accreditation standards of the National Committee for Quality Assurance (NCQA). Dr. Caraballo holds both an undergraduate and medical degree from Brown University and holds a Master of Business Administration degree from The Wharton School of the University of Pennsylvania. He is board certified in Emergency Medicine and is a Fellow of the American College of Emergency Physicians.