If you don’t like the idea of having a colonoscopy, read on. There is new evidence to show that non-invasive, inexpensive screening tests are far better for most people.
An editorial published online in the Journal of the National Cancer Institute says that colonoscopies are no more effective than are fecal occult blood tests in reducing mortality from colorectal cancer. Colonoscopies cost about $2,500 every 5 to 10 years, while fecal immunochemical testing (FIT) costs about $25 a year. (The FIT should be done annually).
A colonoscopy requires a day of “preparation,” (which usually means going on a clear liquid diet and drinking a medication that empties out your colon and rectum), a trip to an outpatient center or doctor’s office, sedation, and the procedure itself.
But a FIT test only requires you to smear a little stool taken off your toilet paper after a bowel movement onto a card for each of three days, and then give the card to a lab to analyze. Honestly, solid research and objective physicians (with no stake in doing colonoscopies) agree that the FIT test is better. So why not? In full disclosure, I take the FIT test every year.
Here are four reasons physicians writing in the Journal of the National Cancer Institute say most people should refuse a colonoscopy and opt for a better and less invasive test:
- The non-invasive method (FIT test) is just as effective in detecting a problem. If that test should be positive, you would then be advised to have a colonoscopy. But if it’s negative, there is no need.
- Colonoscopies have risks: infection, perforation of the colon, bleeding, and issues related to sedation or anesthesia.
- FIT tests do not require a half-day of “preparation” and a day off work for the test, and are far less anxiety-provoking.
- Colonoscopies lead to overdiagnosis. The vast majority of polyps found during colonoscopies are low-risk adenomas and nonadenomatous polyps. Yet current practice says they should all be removed, no matter how small. “When our goal changes… to eradicating every existing polyp, we are taking our eyes off the ball,” the authors say.
But internists and gastroenterologists (who tend to do a lot of colonoscopies, by the way) are probably still going to be proponents of the colonoscopy, at least for a while. The next time your physician urges you to get a colonoscopy, consider showing them the Journal of the National Cancer Institute editorial and saying that you prefer to have a fecal immunochemical test (FIT).
See the National Library of Medicine for more information on the FIT test.