By Anish A. Sheth, MD
Getting a colonoscopy can be a daunting idea.
However, the reality is that a colonoscopy is a routine outpatient procedure that is the best way to prevent colorectal cancers.
By screening for precancerous polyps and existing cancerous lesions, colonoscopies can help you identify problems in the colon and rectum before they start.
The Direct Access Colonoscopy Program at Penn Medicine Princeton Medical Center’s (PMC) Center for Digestive Health helps speed the scheduling of routine screening colonoscopies for patients who meet certain criteria.
The Best Test for Finding Colorectal Cancers
Colorectal cancer, which includes both colon and rectal cancers, is one of the most common cancers in the United States.
It is also one of the most preventable, thanks to colonoscopies, which remain the best way to detect problems in the colon and rectum.
During a colonoscopy, a gastroenterologist uses a thin, flexible tube called a colonoscope, which is equipped with a camera at the end, to examine the inner lining of your large intestine (which includes the colon and rectum).
This device allows the doctor to search for any cancerous lesions or polyps that may be present and to remove them immediately.
Besides colonoscopies, other screening tests are available that may be able to detect colon cancer, such as stool-based tests or a blood test. But unlike colonoscopies, these tests are not able to effectively detect precancerous lesions.
Moreover, if one of these tests detects abnormalities, a colonoscopy will still be necessary for further evaluation and treatment.
Colonoscopies are also more precise and effective than ever before thanks to recent developments in artificial intelligence (AI).
Gastroenterologists at PMC’s Center for Digestive Health are using GI Genius, a (Federal Drug Administration) FDA-approved AI system for colonoscopies. This system uses advanced algorithms to highlight potential polyps during the procedure, drawing attention to small or flat polyps that might otherwise be missed.
What Causes Colorectal Cancers?
Colon cancer often develops from polyps, which are small growths on the inner lining of the colon or rectum. Most polyps, also called adenomas, are benign and don’t usually cause symptoms.
However, over time, some can turn cancerous if not removed.
The American Cancer Society estimates that more than 154,000 new cases of colorectal cancer will be diagnosed in the United States this year, and that nearly 53,000 people will die from the disease.
Though deaths from colon cancer have been declining among older adults, likely because of better and more frequent screening, the death rate for people under age 55 has been increasing by 1% annually since the mid-2000s.
Risk Factors
Doctors aren’t certain what causes colon cancer, but there are certain factors that may increase the risk. These include:
- Older age. The risk of developing colorectal cancer rises with age. Most cases are diagnosed in people over 50, although rates are increasing among younger adults.
- Family history. Having a close relative (parent, sibling, or child) with colorectal cancer increases your risk.
- Certain genetic conditions.
- Personal history of inflammatory bowel disease.
- Diabetes.
- Diet and lifestyle. A diet high in red and processed meats and low in fiber can increase your risk as can smoking, alcohol consumption, and physical inactivity.
The American Cancer Society recommends that individuals at average risk start colorectal cancer screenings at age 45. Those with a family history of the disease should talk with their physician to determine if they should begin screening earlier.
Additionally, anyone experiencing symptoms such as changes in bowel habits, blood in the stool, abdominal pain, cramping or unexplained weight loss should seek prompt medical care.
Direct Access
A screening colonoscopy is an outpatient procedure that generally takes only 15 or 20 minutes.
The Direct Access Screening Program at PMC’s Center for Digestive Health enables patients who meet the following criteria to schedule a procedure without first having an office visit with a gastroenterologist:
- Must be aged 45 or over
- If you have a family history of colon cancer, are 40 or older and have not been screened
- If you have no significant heart, lung, liver or kidney disease
- If you are not on blood-thinning medications other than routine aspirin use
- Must not have a history of stroke or blood clots
Individuals who do not meet these criteria, or those who have specific gastrointestinal complaints, should discuss colonoscopy with their primary care physicians or schedule an appointment to see a gastroenterologist prior to scheduling a colonoscopy.
If you’re 45 or older or have other risk factors, it’s time for a colonoscopy. By removing polyps before they ever have a chance to become cancerous, a colonoscopy can prevent cancer from ever developing.
To learn more about the Direct Access Colonoscopy Program at PMC’s Center for Digestive Health or to schedule an appointment, call (609) 853-6390. For an office visit, press 1. For a Direct Access Colonoscopy, press 2.
To find a gastroenterologist affiliated with Penn Medicine Princeton Health call 1.888.742.7496 or visit www.princetonhcs.org.
Anish Sheth, MD, is board certified in gastroenterology. He is Chief of Gastroenterology and Co-Medical Director of the Center for Digestive Health at Penn Medicine Princeton Medical Center.
