By David Blyweiss, M.D., Advanced Natural Wellness
January 30, 2019
Sometimes it seems like one of the most difficult tasks I have as a physician is getting certain patients to schedule a colonoscopy.
Some of them are terrified the gastroenterologist will be sloppy. Maybe punch a hole through their intestines. Or do something to cause hemorrhaging or an infection. Perhaps cause some other type of permanent or deadly damage.
Others just don’t want to chug down a foul-tasting liquid laxative and spend all night running to the toilet.
In the end, many of them flat out refuse to take part in the process. And I certainly can’t make them do it!
Still, colon cancer is one of the most preventable and treatable forms of cancer when it’s detected early enough. But if it’s not caught in the early stages, it can be one of the most deadly.
This is why it’s recommended that people between the ages of 50 and 75 get a colonoscopy every 10 years.
As far as detection rates are concerned, colonoscopy is the gold standard. It literally allows the doctor to see the inside of your intestines with a tiny little camera. And if he sees a polyp, he can remove it immediately.
But if you can’t bring yourself to go through the process, there are also a few alternatives.
For example, you could opt for a “virtual” colonoscopy. It’s basically a 3D CT scan (CT colonography) of the inside of your colon and rectum. And while it’s not as sensitive as a standard colonoscopy, it is quick, safe and doesn’t require sedation.
However it still requires a full bowel prep with chalky laxatives. It also exposes you to radiation and needs to be repeated every five years. (Plus, if it throws off a false-positive or abnormal result, you’ll still have to undergo a full colonoscopy.)
These days, it’s also possible to detect colon cancer by analyzing your stool. These types fecal tests are excellent for people who refuse to take part in a colonoscopy and don’t want to expose themselves to radiation.
Until recently, the two most common stool tests were the fecal immunochemical test (FIT) and the fecal occult blood test (FOBT). Each of these tests is able to find small amounts of blood in the stool that you can’t see with the naked eye.
If blood is detected, it could be an early sign of cancer or a polyp. However, I find that the detection rates on these are not nearly as good as another type of fecal testing.
My Top Pick for People who refuse to have a Colonoscopy
The company that makes Cologuard® has done a great job at marketing their product. So my patients often ask if it’s really as effective as the television commercials make it sound.
Yes and no.
Cologuard® is great at detecting colon cancer. Compared to colonoscopy, it has 94% and 92% detection rates for early and late stage colon cancer. (This is much higher than the 70% to 74% detection rates for FIT.)
However, it’s only about 42% accurate at identifying small polyps that could become cancerous at a later date. In order to increase the chances of catching these potential pre-cancers, it’s recommended that the test be performed at least once every three years.
But once again, if the results are positive or false-positive, you will still need to go through a colonoscopy to determine if there is a serious health concern.
Still, Cologuard® is one of the best choices for people who fear colonoscopies. And honestly, doing any test is better than doing no test at all.
All you have to do is have your doctor order the kit, collect your sample and send it to the lab. If it comes back positive, I urge you to set your fears aside and take the necessary action to follow-up with a colonoscopy. It could literally save your life.
Martín-López JE, et al. Comparison of the accuracy of CT colonography and colonoscopy in the diagnosis of colorectal cancer. Colorectal Dis. 2014 Mar;16(3):O82-9.
Berger BM, et al. Multitarget stool DNA for colorectal cancer screening: A review and commentary on the United States Preventive Services Draft Guidelines. World J Gastrointest Oncol. 2016 May 15; 8(5): 450–458.