Five Reasons NOT to Get a Colonoscopy

by Columbia Surgery on March 18, 2013

You know how it is. You probably have passed a sign or a billboard reminding you that March is colorectal cancer awareness month. And next month is national sprained ankle month, or whatever it is. Roll your eyes and move on, right?

So – to make sure we don’t bore you with yet another finger-wagging admonishment to schedule your colorectal cancer screening, we have instead decided to share the Top Five Reasons NOT to Get a Colonoscopy.

The top reasons – and the reality behind each – are shared by Daniel Feingold, MD, Associate Professor of Clinical Surgery, Division of Colorectal Surgery at NewYork-Presbyterian/Columbia. He knows – he has heard them all.

1. No one in my family has had colorectal cancer, so I don’t need a screening.

Reality: About 150,000 Americans develop colorectal cancer each year, making it the third most common cancer-related cause of death in the U.S. 85% of these patients have no family history of the disease.

2. My insurance won’t pay for a colonoscopy.

Reality: Almost all insurance plans do pay for screening at the correct intervals. For people at average risk, with no known risk factors, the first colonoscopy should occur at age 50, and then every 10 years thereafter, if the previous results were normal.

3. The wait is too long to get an appointment.

Reality: Anyone can call the NewYork-Presbyterian physician referral line at 1.855.CUSURGE to book an appointment. NYP/Columbia offers screening at three convenient locations.

4. The preparation is too unpleasant. I can’t drink that awful-tasting stuff, and I don’t want to have to spend the evening running to the toilet.

Reality: If you had a colonoscopy ten or more years ago, your memory serves you correctly, because the preparation was rather unpleasant, we admit. Today, however, patients are given just two liters in what is called Low Volume Preparation – this is half of what was used in the past to clean out before a colonoscopy.

5. Colorectal cancer is so uncommon. Why do we have to go looking for it?

Reality: Almost all colorectal cancers begin as a small polyp. If a polyp is found during colonoscopy, it will be removed and this prevents the polyp from every turning into cancer. But if you don’t have your colonoscopy in the first place, then you are throwing away the chance to detect polyps when they are easily treated.

You may wonder, if colorectal cancer is the most preventable cancer, then why is it the third leading cancer-related cause of death in our country? The simple answer: not enough people are having colonoscopies. According to Dr. Feingold, “Almost all patients who get colorectal cancer do so because they have failed to get screenings. Almost all the colorectal cancers would be prevented if people had their recommended screenings.”

Alas, it’s not a sexy topic, but we hope this has given you a little nudge in the right direction. In case you missed it, here is the number to call: 1.855.CUSURGE (855.287.8743).

122514814

Need-to-Know Facts about Colorectal Cancer

  • Colorectal cancer is directly related to age. As baby boomers approach their 70s and 80s, a significant increase in colorectal cancer is expected to occur.
  • Colon cancer is preventable in nearly all cases through proper screening by removing polyps.
  • Polyps may take five to ten years to become malignant.
  • Begin screening at age 50, then every 10 years thereafter unless you have risk factors for colorectal cancer.
  • Conditions that increase the risk for colorectal cancer include ulcerative colitis, Crohn’s disease, inflammatory bowel disease, and familial cancer syndromes such as HNPCC.
  • If a first-degree relative (parent, sibling, child) has colorectal cancer, you are at higher risk.

See frequently asked questions about colonoscopy for more information.

Related Link:
Is Colonoscopy the Right Tool for Colon Cancer Screening?

{ 27 comments… read them below or add one }

Mary Farr March 20, 2013 at 9:39 am

How often do you get these screenings?

Columbia Surgery March 21, 2013 at 1:55 pm

Mary:

I will send your question to Dr. Feingold. As soon as I hear back from him I will let you know.

Columbia Surgery March 21, 2013 at 2:08 pm

Mary:

I found this link on our web site saying that, “In the average risk patient with a normal colonoscopy the test is repeated every 5-10 years.” (http://columbiasurgery.org/pat/colorectal/faqs_colonoscopy.html#when)

I am still going to check with Dr. Feingold to see if this information is current and will let you know what he says.

JOSE A. B. May 8, 2013 at 9:29 am

Dear Colleagues,
Thank you for posting this important and valuable information. I am a four year survivor of colorectal cancer. Thanks to early screening and detection in 2009 by a colonoscopy, I was able to realize that my cramps and bloated stomach were more than just that. Had I not done the colonoscopy, I do not know if I’d be alive today. The colonoscopy is a simple procedure. I have had five colonoscopies done in the past five years and I am grateful that it was able to detect my cancer. Preparation for the procedure is easy, simple and the preparation is much milder and tolerable than in years past. Once you prepare correctly for the colonoscopy by drinking the preparation, all you have to do is show up at your doctor’s office or hospital. They sedate you and the procedure usually takes 30 to 45 minutes. You don’t feel a thing and you have peace of mind knowing that you are being proactive about your health. Colorectal cancer is the most preventable cancer of all. However, many people die from it because of lack of early detection. Give yourself and the ones you love the special gift of life by having a colonoscopy. For all the men out there, do it now!!! Your loved ones will be grateful you did!!!

Just Curious May 8, 2013 at 12:16 pm

Please update us by letting us know when colonoscopies should be done if there IS a family history (first degree relative.)

Natie M. May 8, 2013 at 2:06 pm

I am a CPMC retired RN, still working per diem in the Milstein Interventional Radiology Dept. I am close friends with several RNs in GI IR….I am a guilty party as described above by the great MD Goldstein…

Do you accept Aetna insurance…I did not apply for COBRA with NYSNA…may I make an appointment for screening? No family history of colorectal CA, but mother died of breast CA at a late age, and father had Biliary Cancer, passed away 6 years ago..

Thank you…..may I have your extension in the Milstein Building?

Columbia Surgery May 8, 2013 at 6:09 pm

Thank you, Natie for reaching out to us. We have recently heard from many who are guilty to these practices. We are so glad to hear this article inspired you to make an appointment!

To make an appointment, Dr. Feingold’s office can be reached at: 212-342-1155. According to Dr. Feingold’s NYP Profile, he does participate in AENTA [HMO, PPO, Medicare] but you must verify directly with his office that your insurance is accepted.

Dr. Shamsa May 9, 2013 at 12:41 pm

Dear Collegues.
Thanks a lot for your very interesting article.Don’t you think the most impotant factor for COLORECTAL CANCER is STRESS. As our modern life goes on more complicated and therefor more stressfull ,more cases of this kind of canser will be seen.I know some relatives passed away of this disease which their lives were very stressfull.I think some other chronic factors play a role.Cigarrets, Alcohol ,some Spicey foods,some intestinal worms and many other intestinal mucosa irritant factors. don’t you think so? thanks a lot for your reply.

Columbia Surgery May 13, 2013 at 10:38 am

Thank you for your inquiry. I have forwarded it onto Dr. Feingold, who would be best suited to answer your question. As soon as I hear a response, I will reply.

To contact Dr. Feingold’s office directly, please call 212-342-1155. More information about him can be found on his profile at: http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=df347&DepAffil=Surgery

Columbia Surgery May 13, 2013 at 10:43 am

Thank you for your comment. It’s always great to hear our followers’ opinions. I have forwarded your response to Dr. Feingold, who would be best suited to give his insights into colorectal cancer. As soon as I hear his response, I will reply.

guest August 15, 2013 at 9:48 am

I wonder about your statement that
“why is it the third leading cancer-related cause of death in our country?
The simple answer: not enough people are having colonoscopies”:
how about whatever caused the polyp to develop in the first place, like bad food and unhealthy lifestyle, rather than genetics? That should be addressed. Are there studies about how food, lifestyle, general health, and polyps are related?
Also, I worry about the tools used for colonoscopy, and the potential from passing on “materials” from one patient to the next because of the impossibility of completely cleaning the probe tool (there was such an event in the South some years back).

Columbia Surgery August 15, 2013 at 10:41 am

Thank you for your questions. I am forwarding your comment to Dr. Feingold, who would be best able to give you insights into your concerns. As soon as I hear a response, I will reply.

Columbia Surgery August 19, 2013 at 10:50 am

I have forwarded your comment to Dr. Ravi P. Kiran, Chief and Program Director of our Division of Colorectal Surgery. He has replied with the following:

You are correct regarding the influence of these various factors on contributing to, even if not causing, colorectal cancer. Those listed here are general life-style influences, difficult to quantify and impossible to completely exclude from one’s life. Colonoscopy allows the identification of polyps, which are precursors for cancer, irrespective of whether these occurred due to genetics or other (environmental / life-style) influences. In addition to identifying any early cancer, the destruction of any polyps that are found minimizes the subsequent risk of cancer. We follow stringent guidelines as this relates to the disinfection of colonoscopy equipment.
There is a risk with any procedure, as also with a colonoscopy. However, the risk with colonoscopy is small when performed carefully and the benefits far outweigh any risks.

Thank you again for your comment.

BD Cook October 3, 2013 at 9:47 pm

My niece was diagnosed with colon cancer at the age of 32. She had surgery and was tested for a genetic predisposition for cancer, which she has. This was about 10 years ago.

She underwent a hysterectomy to prevent cancer.

Now she needs a follow up colonoscopy and because she is under 50, her insurance company says they will not cover it and she will have to pay cash. Since she has a history of colon cancer, why wouldn’t the screening be covered no matter what her age?

And does the Affordable Care Act help with any of this? She is currently covered through her employer. Thanks so much for any insight you may have.

Columbia Surgery October 4, 2013 at 11:01 am

Thank you for reaching out to us. I am sorry to hear about your frustrations, unfortunately these questions are best directed at your insurance provider. Each insurance plan is different and we will not be able to address these questions. We will be happy to see your niece for a consultation, but she will need to work with her insurance company to be covered.

Patricia November 15, 2013 at 6:58 am

Sometimes age doesn’t matter. I am a 37 year old woman with no family history. When I went for a colonoscopy just a few weeks ago they found two polyps. One was very small. The other the size if a ping pong ball. The bigger one must have been growing inside me for at least 5 years. It was cancerous. I am very very lucky that regardless or my family history and age, my dr referred me. If I had waited til my 50′s I would have been so far along and probably would have died. I can’t stress enough how important this test is. My children won’t loose their mom at an early age. My life was saved.

russell December 13, 2013 at 4:17 pm

Is It possible to nip spleen during procedure

Columbia Surgery December 16, 2013 at 9:48 am

Russel,

Thank you for the question. I am forwarding it to the Division of Colorectal Surgery, who would be best able to address your question. As soon as I hear a response, I will reply.

To learn more about the Division of Colorectal Surgery, please visit: http://www.columbiasurgery.org/colorectal/index.html You may also reach them directly at 201.346.7001. Best regards.

Columbia Surgery December 16, 2013 at 12:43 pm

Hi Russell,

I have received the following reply from Dr. Feingold:

“Very rarely the spleen can be injured during a colonoscopy. This is a recognized but rare complication.”

I hope this helps answer your question. If you would like to contact Dr. Feingold for an appointment, please call 212-342-1155. You may learn more about him on his Department of Surgery profile, http://asp.cumc.columbia.edu/facdb/profile_list.asp?uni=df347&DepAffil=Surgery

Pamela February 2, 2014 at 9:25 am

Thank you for such helpful information and questions.. I now know I need to find an experienced doctor to get a colonoscopy right away. I had been advised by a doctor that I need to have one. I just kept putting off the thought in denial.

Robin February 21, 2014 at 5:59 pm

Thank you for the informative article, and the Q&A. I have a situation that I don’t believe has been addressed here. My father in-law is due for a colonoscopy this month. His father died of colon cancer 60 years ago, and no one in his family has had colon cancer since then. My father-in-law is 84 years old and has diabetes, dementia, and CLL. My question is – does it do more harm or good to go through this kind of procedure (and under anesthesia) for someone with all of his underlying health issues. And what if he does indeed have colon cancer. He has little interest in much outside his TV and his grandchild), but he is also happy and comfortable. My own father was in a similar situation, and in retrospect, my sisters and I said we would not put him through the aggressive cancer treatment if we had the choice again. It might have given him an extra three months, but it ruined his quality of life. Any advice or links to research (in plain English, please) would be most appreciated.

Columbia Surgery February 24, 2014 at 11:06 am

Robin,

Thank you for your question. I have forwarded it onto our experts at the Division of Colon and Rectal Surgery. As soon as I hear a response, I will reply.

I also wanted to encourage you to attend our Colorectal Cancer Awareness Day, free and open to the public. The event will cover topics such as screening. You can read more about colorectal screenings and what will be discussed during the event in this sneak preview. Thank you.

Columbia Surgery February 24, 2014 at 11:56 am

Robin,

I have heard from Dr. Daniel L. Feingold, who says the following:

“You raised a good question regarding when to stop looking for problems. I do not have enough information to give you a clear, confident recommendation but if your father in law does not have worrisome symptoms that need to be addressed (worsening abdominal pain, unexplained anemia, changes in bowel habits, etc.) I would consider not having a colonoscopy at this point. There are other ways to evaluate the colon like testing the stool for blood, etc. that may be used – I recommend that you speak with his primary medical doctor about these options.”

If you would like to arrange a consultation with Dr. Feingold, please contact his office at 212-342-1155. Wishing you and your father in law the best.

Robin March 11, 2014 at 2:58 pm

Will do. Thanks for your opinion – I appreciate it.

Christie March 13, 2014 at 5:52 pm

I am a 44 year old woman. No family history of colon issues that I know of. I smoke, I drink, I eat pretty badly usually skip breakfast and sometimes dinner if I am drinking beer, I have depression and anxity, and take Lexapro and Zanex. I do not exercise, although work standing up 5 1/2 hours 5 days a week. I sound like a mess, right? Well, I am never hardly EVER sick, maybe 2 colds a year, one sick day a year. I am the right height/weight ratio 5’8, 125 lbs. My blood pressure ALWAYS good. Pretty much a healthy woman, I thought.

On Feb 14, I shoveled heavy snow. A day or two later, I (obviously) had terrible lower back pain. On Feb 17, I moved a sofa. The next morning, the pain was only on the left side, and throughout my whole left pelvis. And I noticed a large bulge in my left lower abdomen when I beared down (to go potty), so I totally freaked out and went to the doctor. She gave me pain pills (great). I took them that night and the next day. It was just like a huge pressure as if pregnant, like I had an orange inside me. I still can’t sleep on my left side for long. I went back to doc 3 days later I said my “people” said it sounded like a hernia, but doc was not sure, so she scheduled me an abdominal US. It came back negative for hernia. I went back to doc again last Thursday, and said I could not poop, and was still in pain/pressure, and she prescribed MetaMucil and she scheduled me for an pelvic US and transvaginal US.

I have always had runny bowels almost every morning when I wake up – for years (I figured from drinking – but it’s almost EVERY morning), and sometimes again during the day, occasionally having more solid stools maybe 3x a week. After 3 days of Metamucil, my stools started emptying. Hooray!!! I said. The ones that have shape are very odd (I figured from being inside for so long). The past 2 or 3 mornings, I had my usual runny stools. Today I called the doc for my results from the US’s from yesterday. The results were NEGATIVE for anything wrong with ovaries (since not a hernia, I thought ovarian cyst), uterus, etc. everything was normal. Now I’m wondering colon issues, intestinal blockage.?.? My semi-formed stool this afternoon looked like it might have blood in it, and was rounded, but had a valley in one side like if you took a pencil and pulled it through it 1/4 inch from end to end. Maybe too much info, but it’s kindof freaking me out again.

I asked her (the lady who gave me the ultrasounds yesterday) about colon cancer, and she said I could get a colonoscopy any time I wanted to. I feel like I KNOW something is wrong with me. Now just today, my upper area under my rib cage also hurts. The colon goes up and around there, right? The pain in the left side has decreased since I started going “poop” again, but it is still there, along with the weird bulge.

Thank you for any ideas.

Columbia Surgery March 17, 2014 at 10:33 am

Hi Christie,

Thank you for sharing your story. Unfortunately without a complete medical examination, we cannot offer the advice you see. If you would like to make an appointment with the Division of Colon and Rectal Surgery, please call 212.342.1155. Thank you.

JA April 29, 2014 at 9:46 pm

@Christie – I have the same symptoms,

You can literally see and feel the lump under my ribcage which is where it hurts.

Dr can’t figure it out :-(

Thank You

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