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The value of colonoscopy screening at South Denver GI

What is a Colonoscopy?

A colonoscopy is an exam used to identify abnormalities or changes in the colon and rectum. The procedure uses a flexible scope with a camera to view and examine the inside of the large intestine. Colonoscopy evaluates for causes of various gastrointestinal symptoms, and screens for and removes potentially precancerous polyps.

Colonoscopy is considered the gold standard in colorectal (colon) cancer screening and prevention. Among the options considered for colorectal cancer screening, colonoscopy is the only tier-one test where the goal is prevention. Colonoscopy is also the only screening test that can prevent and detect colorectal cancer.

Colon polyps are benign but potentially precancerous growths located on the lining of the large intestine. They cause no symptoms. If colon polyps are not removed, they have the potential to grow larger over time and can turn into colorectal cancer. The risk of colon cancer is significantly reduced by safely removing these polyps during colonoscopy, and then repeating colonoscopy at an interval based on individual risk factors to remove new polyps.

When Do I Start Screening for Colorectal Cancer?

The American Cancer Society and the US Preventive Services Task Force recommend that average-risk patients begin screening colonoscopies at age 45. Individuals who have risk factors for colorectal cancer, such as a first degree relative with a history of colorectal cancer or polyps, inflammatory bowel disease, certain digestive diseases or genetic conditions that can increase the risk of colorectal cancer, may need to have a colonoscopy younger than age 45.

How Often Should I Have a Colonoscopy?

The interval between colonoscopies for an individual depends on their personal risk factors and findings of previous colonoscopy exams. Some people grow more polyps than others or may develop colon polyps at a younger age, even with no known family history of colorectal cancer.

People are also more likely to develop precancerous colon polyps as they age. Based on the findings on your initial (screening) colonoscopy, a recommendation will be made on when to repeat the screening test. This is usually several years later, though very high-risk findings may indicate a need to repeat a colonoscopy sooner. In patients who have no precancerous colon polyps detected on their initial colonoscopy, and with no other risk factors such as a family history of colorectal cancer, the colonoscopy is typically repeated 10 years later.

I Have No Symptoms and No Family History of Colorectal Cancer. Am I Still at Risk?

Polyps are potentially precancerous growths that cause no symptoms. Preventing colorectal cancer is particularly difficult without colonoscopy because symptoms typically do not occur until cancer has progressed to more advanced stages or grown large enough to cause symptoms like bleeding. For patients who have certain symptoms, colonoscopy is important to identify the cause. However, colonoscopy for prevention of colorectal cancer is crucial even for patients with no symptoms.

Colorectal cancer is the third leading cause of cancer-related death in the United States in both men and women. If you combine genders together, it is the second leading cause of cancer-related death in the U.S. A vast majority of colorectal cancer occurs in individuals who have no known family history of the cancer, highlighting the importance of colonoscopy for prevention in all patients, regardless of symptoms or known risk factors. It is also important to note that African Americans are around 20% more likely to get colorectal cancer and are about 40% more likely to die from this disease when compared to other races. There are more complicated factors that can increase cancer risk for an individual aside from family history of colorectal cancer, and these should always be highlighted when discussing colonoscopy with your South Denver GI gastroenterologist or other health care providers.

How Do I Prepare for My Colonoscopy?

Prior to a colonoscopy at South Denver GI, you will need to empty out the colon and adequately clean the walls of the large intestine so that your gastroenterologist can view the surface in its entirety to search for polyps and other findings. There are multiple types of bowel preparation, with options available to tailor to the individual needs of a patient. In general, preparing for your colonoscopy includes:

  • Minor changes to the diet starting 1 week before the exam, such as avoiding seeds.
  • Avoid eating solid food the day before the exam.
  • You may need to adjust your medications before the procedure. Changes are sometimes needed for heart conditions, diabetes, high blood pressure and blood thinners. Please speak to your doctor at least one week before your colonoscopy.
  • You will take a bowel preparation, either in liquid or pill form, usually starting the day before the procedure.

What Happens on the Day of the Colonoscopy?

After checking in at a South Denver GI endoscopy center, getting an IV placed and consenting for the procedure, you will go to the procedure room where sedation will begin. A colonoscopy typically takes 20-30 minutes and you should remain comfortable throughout the procedure. With the camera inserted into the rectum and advanced to the beginning of the large intestine, your doctor will use an external screen to examine for precancerous polyps or other abnormalities. Tissue samples may be taken during the procedure, and polyps are removed, if found. Taking tissue samples causes no pain, as the lining of our intestines lacks the pain sensors that exist in our skin.

Once the exam is complete, you will wake up in the recovery area for about 30 minutes and then your pre-assigned driver (family or friend) will take you home.

What Type of Sedation Will I Get for My Colonoscopy?

The form of sedation used for minimally invasive procedures like colonoscopies is “moderate sedation.” Patients are still breathing on their own throughout a colonoscopy, as this is not “general anesthesia” that is typically used for bigger surgeries. Patient comfort is the goal of sedation. If you have concerns about the type of sedation used for your colonoscopy, please discuss this with your referring doctor or with South Denver GI at least 2 weeks before your procedure date.

When Will I Learn the Results of My Colonoscopy?

Your gastroenterologist will discuss the results of your colonoscopy immediately after the procedure. If you wish, these results can also be discussed with your driver, as sedation can sometimes alter our ability to remember conversations in the recovery area. Polyps are very common, and most can be confirmed as benign just based on visual appearance to your gastroenterologist. All tissue samples and removed polyps are sent for microscopic examination. These results will be reviewed by your gastroenterologist and communicated to you and your referring doctor by phone or mail, usually 1-2 weeks following the procedure.

Colonoscopy FAQs

Is Cologuard better than a colonoscopy?

A colonoscopy detects over 95% of all colorectal cancers, while Cologuard detects 92% of colorectal cancers and only 42% of precancerous polyps. Cologuard has also been shown to have a 13% false positive rate. This means that 1 in 10 Cologuard tests will incorrectly identify colorectal cancer or polyps. If a Cologuard test comes back positive, patients will need to have a colonoscopy to remove any polyps. Because of these statistics and limitations of Cologuard, a Denver colonoscopy is the most effective colon cancer screening and prevention option.

What is an adenoma detection rate?

An Adenoma Detection Rate (ADR) measures the average rate of precancerous polyps that a doctor identifies and removes in each colonoscopy. This is an important rate for patients to know because for every 1% increase in the doctor's adenoma detection rate, there is a 3% decrease in the odds of the patient developing colorectal cancer over the next decade. South Denver GI physicians consistently achieve adenoma detection rates that exceed national benchmarks.

Do you get colonoscopy results immediately?

You will receive your results immediately after your colonoscopy. Your doctor will speak with you regarding the findings, if any polyps were found and the next steps in your care. Pathology results (removed polyps, biopsies) may take up to two weeks.

Is colonoscopy a painful procedure?

As you will be sedated during the colonoscopy, you will feel very little to no pain.

When should I be screened for colorectal cancer?

All adults should be screened for colorectal cancer beginning at age 45. Those who are at increased risk for colorectal cancer, based on family history, ethnicity or other factors, may need to be screened an earlier age.

What exactly happens during a colonoscopy?

During a colonoscopy in Denver, the doctor will insert a flexible scope into the rectum to check the colon and rectum for any abnormalities, including precancerous polyps. The main goals of a colonoscopy are to prevent colon cancer, by removing polyps, and to determine the cause of abnormal GI symptoms.

What happens if they find cancerous polyps?

If your doctor finds polyps during a colonoscopy, he or she will remove the polyps and have them tested to see if they are cancerous. If the biopsy detects colorectal cancer, your doctor will then determine the best course of treatment and explain the next steps.

What is the best type of colorectal cancer screening test?

The best and most effective colorectal screening test is a colonoscopy. It is considered a tier-one screening test by the New England Journal of Medicine.

Why should I get a colonoscopy?

A colonoscopy is the only screening test that can detect and prevent colorectal cancer. It is considered the gold standard for colorectal cancer screening and may also be used to investigate possible causes for abdominal pain, rectal bleeding and other intestinal issues.

When can I go home after a colonoscopy?

Patients can feel free to return home immediately after their Ridgeview Endoscopy Center, Castle Rock Endoscopy Center or South Denver Endoscopy Center colonoscopy. However, you will need to arrange for a friend or family member to drive you home, or an approved driving service. You cannot drive yourself.

These people were all extremely professional and kind. The bedside manner from all staff was great and they were thorough with all information. Medical stuff is hard to deal with, but with people like this, the discomfort was eased. I highly recommend this office to anyone needing this type of help.

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My experience with South Denver GI has been outstanding. Everyone I have met on the staff is exceptionally professional with tremendous people skills. Top-notch practice that I would unequivocally recommend to anyone.

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The front staff was immediately attentive as soon as I walked in. The nurses and PAs were professional and very nice, and the doctors were even better. The procedure went smoothly and could not have gone better. Of course, having positive lab results makes it easier to post a glowing report but I got the impression that if I had been diagnosed differently, they would have taken care of me with the same kindness and dedication.

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