Colonoscopy, is it really necessary?

The deputy chief physician of the Department of Gastroenterology at Jingdong Zhongmei Hospital said that among the 14 people who underwent colonoscopy, 13 had precancerous lesions, and 1 was diagnosed with colon cancer! As a gastroenterologist, Yong Wu has always spared no effort to popularize the importance and necessity of colonoscopy to relatives and friends.

In particular, having a colonoscopy or gastroscope before the age of 40 can find many problems and stop the damage in time to avoid more serious consequences. However, the power of one person is far from enough. Raising people’s awareness of colonoscopy requires the joint efforts of more people.

1. Why do you have to do a colonoscopy?

One of the reasons why many people refuse colonoscopy is the fear of the unknown. I don’t know if the colonoscopy is painful or not, and if the colonoscopy will detect anything wrong… So I simply choose to escape. However, if you dare to face it once, you may be able to “save your life”!

Although the incidence of colorectal cancer has been increasing in recent years, it is one of the preventable cancers.

Generally speaking, it takes about 5-10 years to develop from intestinal polyps to colorectal cancer. If there is no cancer, early screening finds clues, which can be stopped in time and reduce the risk of colorectal cancer. Therefore, early screening is very important, especially for people at high risk of colorectal cancer.

A large study published in the Annals of Internal Medicine in 2018 also provided strong evidence for the importance of colonoscopy. The study looked at 25,000 patients and found that between 2002 and 2008, about 5,000 were diagnosed with colorectal cancer and died of cancer in 2010.

After analysis, the study found that most patients who died of colorectal cancer ignored colonoscopy. Further comparing screening data over the past 20 years, the researchers concluded that colonoscopy could reduce the risk of death by 61%.

In addition, the Stanford University team also pointed out the role of early colonoscopy in reducing the risk of colorectal cancer. Based on data from 6 million people, the study found that among people aged 45-49, those who underwent colonoscopy had a 50% lower risk of developing colorectal cancer compared with those who did not.

Wang Xishan, director of colorectal surgery at the Cancer Hospital of the Chinese Academy of Medical Sciences, said that in recent years, the incidence and mortality of colorectal cancer in the United States have continued to decline. In contrast, China is still showing a slow upward trend.

The reason, Wang Xishan believes, is mainly due to the low penetration rate of endoscopy in my country. Since 2000, colonoscopy has become the main screening item in American physical examination, and the colonoscopy rate of people over 50 years old has risen to 60 % in 2015. In addition, the death rate from colorectal cancer in the United States has dropped by about 53% since 2000 compared with 1970.

However, in China, the penetration rate of gastroenterology is still low, and the rate of colonoscopy in people over 50 years old is less than 15%.

2. How long is the “validity period” of a colonoscopy?

How long can you be safe after having a colonoscopy? The answer is 10 years.

Li Zhaoshen, an academician of the Chinese Academy of Engineering, suggested that people who have not had a colonoscopy before the age of 45 must hurry up and do it once. Do a colonoscopy, the safe period is about 5-10 years.

A 20-year follow-up study published in The Lancet in 2017 found that colonoscopy can reduce the incidence of colorectal cancer by about 30% over the next 17 years.

It should be noted that it is not a matter of having a colonoscopy to sit back and relax and reduce the risk of colorectal cancer to zero. Maybe there were no intestinal polyps at the time of colonoscopy, but they may grow later, so it is recommended to do it every 5-10 years.

In addition, if there were intestinal polyps at that time, it was found after the colonoscopy and cut off, and they may grow again later, so they should be reviewed regularly.

However, a colonoscopy can guarantee that you will not get colorectal cancer for 5 or 10 years.

3. Who is best to have a colonoscopy?

Does everyone have to have a colonoscopy? Not really. For some people, there is no need for a colonoscopy for the time being. However, for people at high risk of colorectal cancer, or those with early symptoms of colorectal cancer, if they have not done colonoscopy, they should hurry up and do it.

1. Changes in stool characteristics

Small symptoms may indicate major problems. When there are symptoms such as blood in the stool or black stool, mucus or pus and blood in the stool, increased defecation frequency, deformation of the stool, alternating diarrhea and constipation, and difficulty in defecation, you should be vigilant and have a colonoscopy as soon as possible. Check to find out why.

2. Unexplained changes in the body

Abnormal changes in the body, such as significant weight loss in a short period, unexplained anemia, abdominal mass or mass, elevated carcinoembryonic antigen, may also be a sign of colorectal cancer, and a timely colonoscopy is required.

3. Postoperative patients with colorectal cancer

After colorectal cancer surgery, colonoscopy needs to be reviewed every 6-10 months to prevent a recurrence. If a colonic obstruction occurs before surgery and the entire colon cannot be examined, a colonoscopy should be done 3 months after surgery.

4. People over 40 years old

People over the age of 40, especially those with long-term poor eating habits and frequent drinking, should have a colonoscopy. In addition, people with a family history of colorectal cancer, even if they do not experience any unpleasant symptoms, should have a colonoscopy as soon as possible, just in case.

So, what do you need to do to prepare for a colonoscopy?

First of all, the night before the colonoscopy, it is best to fast for dinner, or only eat a moderate amount of liquid food.

Secondly, do not drink dairy products such as milk, and do not eat fiber-rich vegetables, fruits, tomatoes, watermelons, and other foods with red juice, so as not to affect the correctness of the test results.

Finally, be sure to take the laxative prescribed by the doctor. The role of the laxative is to clean the intestines. Don’t sit after taking the medicine, you can walk back and forth to promote excretion.

Therefore, colonoscopy is not terrible. What is ” terrible ” is the need for colonoscopy, but the people who do not do it for a long time. Prevention of colorectal cancer starts with colonoscopy. If you belong to the group of people who need a colonoscopy, hurry up and do it as soon as possible!

By Cary Grant

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