The Medical Test No One Wants to Talk About

Mention the word “colonoscopy” and many people immediately plug their ears and want to think about anything else. But when my patients turn 50 – or if they’re younger and there’s a family history of colon cancer – it’s something I have to bring up, whether they want to talk about it or not.

Many people have a lot of misconceptions about colonoscopies or think it’s a waste of time, but they are an important test that can literally mean the difference between life and death. Colonoscopies are a screening tool for colorectal cancer, which is the second leading cause of deaths due to cancer. And it’s treatable – if it’s caught early enough. That’s what colonoscopies do. They discover and remove any abnormalities in your colon.

I think some people are afraid of colonoscopies because they don’t know what to expect. Once you make an appointment, you’ll get instructions on what you’ll need to do to prepare. About 18 hours before the procedure, you’ll take a special laxative that will clean out colon and provide the best screening results. Leading up to the colonoscopy, you won’t be able to eat for four to six hours.

During the procedure itself, which is done in an outpatient surgery center, you’ll be heavily sedated so you won’t feel what’s happening. A surgeon will guide the scope, which contains a small camera, all the way up the colon. As it’s slowly withdrawn, the surgeon will look for discoloration, scar tissue or polyps, which are a growth on the surface of the colon, which is also known as the large intestine. If a polyp looks suspicious, it can often be removed. If your scan comes back clean, you won’t need another one for 10 years unless there’s a family history of colon cancer. If there is a history of colon cancer in your family, make sure you tell your medical provider right away.

If any polyps are removed, they will be biopsied to make sure they aren’t cancerous. Only about 5 percent of polyps removed turn out to be cancerous. Regardless of the outcome, your surgeon will provide you with any follow-up information so you know what to do next. In addition, the surgeon shares that information with your family medical provider so we know how things went and what to keep an eye on.

Another screening option available for colon cancer is a Fecal Immunoassay Test (FIT). Given annually, FIT looks for traces of blood in a patient’s stool. Patients can either undergo an in-office digital rectal exam or can choose a take-home kit, which allows them to submit a single stool sample through a pre-addressed, postage-paid mailer.

While colonoscopies are still the preferred method for finding and immediately treating colon cancer, FIT is a good alternative. Bear in mind that if the FIT comes back positive for blood in the stool, a colonoscopy will be necessary.

Whether you choose a colonoscopy or FIT, it’s essential you get screened for colon cancer if you’re over the age of 50 or have a family history of the disease.

Scott Schuldes is a certified family nurse practitioner and associate medical director at ThedaCare Physicians-Hilbert. He can be reached at