Bowel Check - The Facts

What is Colonoscopic Screening ?

A colonoscopy to look for polyps is the best way to assess your personal risk of developing bowel cancer in the future. If there are no polyps, the risk of developing bowel cancer in the next 7-10 years is extremely low. Colonoscopy is the only reliable test for detecting polyps and preventing bowel cancer.

What are polyps ?

Healthy colon

Colon with polyp warranting
further investigation

Polyps are small protrusions of tissue growth found in the colon. Over several years, some of these polyps grow larger and eventually some become cancerous. Removal of polyps at an early stage therefore will prevent bowel cancer.

What happens if polyps are found?

If polyps are found at the initial colonoscopy, they will be removed. Future surveillance colonoscopies (at 3 or 6 yearly intervals depending on the size and number of polyps found) can prevent bowel cancer developing.

Do polyps or early cancers cause symptoms I can detect?

Usually polyps or early bowel cancers cause no symptoms, so testing is carried out on healthy individuals without bowel symptoms

Does my age or family history matter?

The most appropriate age at which to consider screening colonoscopy should be decided in consultation with your doctor and will depend on whether or not you have a family history and the age at which your relatives developed bowel cancer or polyps.

For those without any family history of bowel cancer, the ideal age is 55 years. While the absence of a family history is associated with a decreased personal risk, it should be remembered that in terms of numbers, more bowel cancer actually occurs in those without a family history, because there are many more such individuals in the population . For those without a family history, the risk increases with age, from late 50s and increases progressively through the 60s, 70s and 80s.

Individuals with a family history have an increased risk and may develop polyps or cancer at an earlier age. Depending on family history, a screening from 55 years of age to as low as 35 years of age may be appropriate.

What does a colonoscopy involve?

A fibre optic instrument containing a tiny video camera is inserted into the rectum and steered for about 70-100 cm around the colon (lower bowel) until it reaches the end of the small intestine. The interior lining of the bowel is viewed on a monitor for polyps. If any are discovered, they are removed by a diathermy current and sent for biopsy report. This procedure is done under ?sleep sedation? using intravenous drugs. The procedure induces little or no real discomfort. Click here to view a video of a colonoscopy - 1.5MB download.

How much preparation is required?

Detailed instructions will be provided and there will be a few dietary restrictions in the days leading up to the procedure. One day prior, only liquid nutrients are allowed and a period of bowel cleansing involving oral laxatives and the intake of water is required.

How will I feel after the colonoscopy?

After resting for an hour and having something to eat, the majority of patients feel absolutely fine and are able to go home, however, driving is not possible for 8 hours after sedation.

Are there any risks or complications?

Any medical operation involves a small element of risk. Colonoscopy is generally a safe procedure and significant complications are very unusual. Bleeding and perforation are possible complications particularly after polyp removal and very rarely these have lead to serious outcomes. Complication rates are reported for patients with symptoms being investigated and include polypectomy procedures. Bleeding after polypectomy occurs in 1/300 patients and is usually not a major problem. Perforation and mortality rates are reported as 1/1000 and 1/10,000 - 16,000 respectively. With today’s modern equipment and operator skill, problems are exceedingly rare.

Can polyps or cancers be missed after a colonoscopy?

This is possible. Sometimes it is technically impossible to complete the examination and if so a follow up barium enema X-ray maybe requested. Very small polyps (under 5mm) maybe missed. Failure to adequately prepare the bowel increases the likelihood that some polyps may be missed.

What happens after the colonoscopy?

It is usually advisable to spend a quiet evening at home after the procedure and to resume normal activities and return to work the following morning. The results of any pathological examination of polyps or biopsies will take a few days to come through. The results will be communicated to you and to your general practitioner. If there are issues about future surveillance then a follow up appointment to discuss these with a gastroenterologist will be provided.

How much does it cost?

The procedure currently costs NZ$1100-1400 (GST inclusive). The actual price depends on whether polypectomy procedures are required or not during the procedure.