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August 08, 2017

What you need to know about getting a colonoscopy

Prevention Colonoscopy

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Colorectal cancer is the third leading cause of cancer-related deaths among men and women in the United States. The good news is it’s a highly treatable condition when it’s detected early. The best way to detect it — and to prevent it from progressing — is a colonoscopy.

Is a colonoscopy as bad as it sounds?

When it comes to colonoscopy, people tend to think of the negatives. For example, you’ve probably heard a lot about the preparation that precedes a colonoscopy: No solid food the day before, drinking a laxative…and you can probably guess what happens next.

While the prep isn’t the most pleasant thing, it’s necessary to ensure that your doctor is able to recognize abnormalities in your large intestine during the screening. These may include ulcers, colon polyps, tumors, and areas of inflammation or bleeding.

The procedure itself takes less than an hour, during which you’re under light sedation. A doctor will use a colonoscope (a flexible tube with a light and a camera) to examine the length of your colon. When the procedure is done, you’ll wake up hungry and ready to head home…of course you’ll need to arrange for a ride home in advance.

No matter what, the benefits of colonoscopy far outweigh the temporary inconvenience: Not only is a colonoscopy the most effective tool to catch colorectal cancer early, preventing complications and even death, but if a precancerous growth is found, it can be removed then and there.

“No one ever died of embarrassment”

As a physician who knows the benefits of early detection, it’s sometimes easy to forget that many patients are intimidated by the idea of getting a colonoscopy. In fact, one in three eligible adults put it off. Why? Well, as we know, it’s certainly not as easy as getting an X-ray. But perhaps the biggest barrier is obvious: embarrassment.

It’s natural for people to feel hesitant about undergoing a somewhat invasive screening like a colonoscopy, but it’s critical that they overcome their reluctance. To me, it boils down to an advertisement a gastroenterologist ran in my local newspaper: “No one ever died of embarrassment.”

Other less-invasive colorectal cancer screening options exist, such as sigmoidoscopy and take-home kits that test for hidden blood in the stool (one popular kit is the FIT test). These are valuable screenings too, but, it’s important to keep things in perspective: A colonoscopy is a temporary inconvenience, like getting an oil change or visiting the dentist. But once you get a colonoscopy, you won’t need to get another one for ten years if everything is normal and you are of average risk.

Getting more people screened

Nothing underscores the importance of colonoscopy and preventive screenings more than Independence Blue Cross’s commitment to encouraging our members to adhere to colonoscopy recommendations, including offering paid time off for our associates to have preventive screenings:

  1. We signed the 80% by 2018 pledge to work with the National Colorectal Cancer Roundtable to reach an overall testing rate of 80% of people eligible for screenings, both members and associates, by next year. IBX members can sign up to receive text or email alerts reminding them when this and other important screenings are due.
  2. IBX is also participating in the Reducing Cancer Disparities by Engaging Stakeholders (RCaDES) project with Thomas Jefferson University. The RCaDES Learning Community achieved an 80 percent compliance rate by using culturally-competent navigators to visit communities to discuss the importance of colonoscopy.
  3. Our providers are given lists of members eligible for screening. The providers then offer these members annual fecal immunochemical tests (FIT) to take at home. In addition, the Quality Incentive Program (QIP) program pays primary care providers to close gaps in colorectal cancer screenings.

When to get a colonoscopy

So when should you get started? People at average risk for colorectal cancer should get their first colonoscopy beginning at age 50. If your risk factors are higher, you may need to get your first screening sooner. Talk to your doctor to find out the best time for you to get your first colonoscopy.

This article was originally published on IBX Insights.

About Dr. Victor Caraballo

Dr. Caraballo is Senior Medical Director of Quality Management for Independence Blue Cross. In his role, Dr. Caraballo is responsible for all activities associated with ensuring health plan compliance with the accreditation standards of the National Committee for Quality Assurance (NCQA). Dr. Caraballo holds both an undergraduate and medical degree from Brown University and holds a Master of Business Administration degree from The Wharton School of the University of Pennsylvania. He is board certified in Emergency Medicine and is a Fellow of the American College of Emergency Physicians.

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