Colon Cancer FAQs

Colorectal cancer is the second leading cause of death in men and women combined in America. Screening by colonoscopy can prevent cancer by finding precancerous growths at an early stage. During screening, a doctor looks for polyps (abnormal tissue growth) or cancer. If polyps are found, they can be removed immediately. Precancerous polyps are removed before they have the opportunity to develop into cancer.

• The American Cancer Society recommends that men and women should get a colonoscopy when they turn 50; and earlier for individuals of African-American descent.
• Individuals with a family history or a family member recently diagnosed with colon cancer, regardless of their age should have a colonoscopy.
• Individuals experiencing rectal bleeding, black stools, blood in stool, diarrhea or constipation that lasts for several days, weight loss or abdominal pain and cramping should be evaluated by a gastroenterologist and possibly get a colonoscopy.
• Anyone with a positive result on another colorectal cancer screening test should have a colonoscopy.

• Always follow the physician’s advice regarding test frequency depending on your personal health and your family history.
• Starting at age 50, if an individual has a colonoscopy with no polyps discovered, they will likely not need to repeat the test for 10 years.
• Those with non-cancerous polyps may be told to repeat their colonoscopy in 5 years.
• Individuals with more serious adenomas or high-risk patients may need the exam every one to three years.  Your gastroenterologist will decide the interval dependent upon your lab results.

The colonoscopy normally takes about 20-30 minutes. If polyps are found, the doctor will remove each one, properly preserving it for laboratory testing. This can take another 5-15 minutes, depending on the number of polyps.

• Bowel preparations are chosen after speaking with the patient and determining whether there are health risks preventing them from using certain preps.
• There are over-the-counter (OTC) and prescription preps available. OTC options work for most patients, are usually less expensive, and may be ordered as a one-day or two-day preparation, depending on the patient’s bowel habits.
• The doctor may have a preference they feel is most effective, but they will also consider patient preference if the patient has normal bowel patterns and no adverse health considerations.

• The following is an example of one of the bowel preparations we sometimes use. There are additional instructions on our resources page. We offer video instructions of our most common colonoscopy preps in English and Spanish on our YouTube channel found here.
  • A couple of days before, purchase the supplies to prep for the procedure, which consist of a box of Dulcolax laxative tablets, a 238-gram bottle of MiraLAX and a 64-ounce bottle of Gatorade (sugar-free or regular, or something similar). Just don’t choose anything red or purple, as that can alter the visual exam of your colon.
  • The morning before the procedure, stop eating solid foods and dairy products, until after your procedure. Drink 64 ounces of clear liquids throughout the day and evening, in addition to your bowel prep mixture. At 4 p.m., take four of the Dulcolax laxative tablets. At 5:30 p.m., you can prepare and drink the bowel prep. To do so, just mix the MiraLAX with the Gatorade (or other clear drink you chose). Drink half of the solution over the next two hours. Set aside the rest of the solution for the next morning. It’s important to stir or shake the solution well before each time you drink the solution to ensure you’re getting an even dose of the MiraLAX.
  • 4 hours before your arrival time, drink the remaining Gatorade and MiraLAX solution (ensuring to shake or stir it well) within two hours. Take your regularly prescribed medications, except diabetic medications no less than 2 hours before your arrival time. If you’re diabetic, don’t take your insulin or oral medication. Instead, bring your morning blood sugar reading with you to the appointment. And if you use an inhaler, please also bring that to your appointment.
  • Two hours before your arrival time, do not drink or ingest anything else. This includes water, ice and gum. Arrive on time and we will take it from there.

As with any medical procedure, there are some risks, but colonoscopy complications are rare and far outweigh the risk of not having a screening performed. Although every possible precaution is taken to keep the patient safe during a colonoscopy, there is a small risk of bleeding, bowel tears and infection.

The most common and comfortable practice is to use moderate sedation to allow the patient to sleep through the procedure. The sedation we use is a non-narcotic that dissipates quickly leaving only a four-hour wait to drive, make legal decisions or perform activities requiring coordination. However, for those with health concerns or who are unable to find a responsible driver to help them on their procedure day, they can opt for a non-sedated colonoscopy.

If your gastroenterologist finds polyps during the colonoscopy, he or she will remove each polyp during the procedure to prevent them from growing or developing into a cancer. Polyps are then sent to a pathology lab to determine whether they are cancerous.

The moderate sedation we use prevents discomfort as you sleep through the procedure and polyp removal, if needed. If you have your procedure without sedation and feel pain during it, let your doctor know immediately.

• Always contact your insurance provider to check eligibility on your plan.
• Most every insurance provider will cover a screening colonoscopy for patients 50 and over. If polyps are found, pathology may be covered as described in your individual plan, but it is in addition to the cost for a screening colonoscopy.
• If you are having symptoms and the colonoscopy is to investigate those symptoms, your insurance will categorize the procedure as “diagnostic” and they will pay according to their plan for these types of procedures.
• Some insurances have a level of colonoscopy coverage for those younger than 50 with family history indicating cancer.