Colorectal cancer is the second leading cause of cancer death in the US, accounting for more than 50,000 deaths each year. Catching and removing polyps before they have a chance to turn into cancer is a primary goal of colorectal cancer screening. Even when colorectal cancer is present, early discovery produces a gratifying 90% survival rate. Findings show that regular screenings are the key to reducing colorectal cancer deaths. That’s why there has long been a push to get people 50 and older to begin receiving colorectal cancer screenings. Because recent data show an increase in cases among people under 50, the American Cancer Society has revised its guidance for colorectal cancer screenings, recommending that people at average risk begin routine screening at age 45. Individuals at an increased risk, including those with a personal or close family history of colorectal disease, an inflammatory bowel disease like Crohn’s or ulcerative colitis, type II diabetes, certain congenital syndromes, or prior treatment for testicular or prostate cancer, may be wise to begin screening earlier. Also at increased risk are Black people and Ashkenazi Jews, who, for reasons not yet understood, are more prone to colorectal cancer than other groups.
Risk can also be elevated by lifestyle factors such as smoking, being overweight, physical inactivity, moderate to heavy alcohol use, and a diet high in red meats like beef, pork, liver, lamb, hot dogs and processed lunchmeats.
Virtual Colonoscopy – A Safe, Less Invasive Alternative
As an alternative for people wishing to avoid conventional colonoscopy screening, the American Cancer Society recommends virtual colonoscopy as an effective screening tool for average-risk patients without symptoms of abdominal or bowel disease.
Virtual colonoscopy uses low-dose computed tomography (CT) to create highly detailed cross-sectional images able to catch most polyps and lesions as effectively as standard colonoscopy. It delivers a small radiation dose that leaves the body once the exam is over. Because the scope’s extension into the bowel is modest compared to standard colonoscopy, virtual colonoscopy produces less risk of bowel perforation, making it safer for people who are older, ill or frail, take blood thinners, have severe breathing issues or suffer from bowel obstruction or narrowing.
In about 15 minutes, virtual colonoscopy can accurately screen for polyps and colon cancer, as well as identify abnormalities in the lower digestive tract, the inner lining of the colon and the rectum.
This minimally-invasive exam not only compares to the sensitivity of a standard colonoscopy, it allows examination of the adjacent organs and tissues for added information and security. Virtual colonoscopy is much quicker than a standard colonoscopy, and because it does not require conscious sedation, patients can drive themselves to and from their appointment and resume normal activities immediately afterward.
Preparation for Virtual Colonoscopy
One thing both virtual colonoscopy and conventional colonoscopy share is a burdensome preparation, which most patients consider to be the most taxing part of screening. You will be given detailed instructions and prescribed a combination of laxative pills and liquid laxative. Starting the evening before your appointment, you will drink a half-gallon of liquid laxative, spacing your consumption over the hours until bedtime. In the morning, about six hours before your appointment, you will drink the remaining half-gallon. During this time, it is advised that you stay home, as your bowels will empty completely.
We admit, this prep is no walk on the beach – but once it is completed, the most challenging part is, well, behind you.
After you arrive for your appointment, you will drink a safe contrast liquid that coats the inside of the intestine for easy, accurate imaging. You will lie down on a padded exam table and a highly trained technologist will gently guide a short, thin tube through the rectum to carefully expand the intestine with air, enabling clear, detailed images to be captured. Though it creates a feeling of fullness, most people do not find it painful. The table slides into the CT scanner while images are captured. Minutes later, the exam is over. You may experience some temporary bloating, but otherwise you are free to carry on with your day.
The great news is that if your virtual colonoscopy shows no signs of cancer, you likely won’t have to do it again for another five years. So, if you’re 45 or older and at average risk for colorectal cancer, talk to your referring clinician about whether virtual colonoscopy is right for you. Remember, colorectal cancer can be treated, even prevented entirely. Routine screening is worth the effort – no buts about it.
