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Alternatives to Colonoscopy
There's good news for anyone dreading their next colonoscopy: they may never have to take it.
A new report from the American College of Obstetricians and Gynecologists (ACOG) stresses that women now have several acceptable colon cancer screening options. They should choose whichever test they're most willing to follow through with. While the report is addressed to women, its recommendations apply to men, too. Colon cancer doesn't discriminate. More than 50,000 U.S. men and women died from colon cancer in 2010.
Fecal occult blood tests and flexible sigmoidoscopy are considered effective alternatives to colonoscopy.
A fecal occult blood test (FOBT) detects hidden blood in the stool, which can be a sign of colon cancer. The patient takes a stool specimen at home and sends it in for testing. They should be done once a year.
Flexible sigmoidoscopy is similar to a colonoscopy but less extensive, only covering the lower colon. It has a lower risk of complications than colonoscopy and can be performed without sedation. Recommendations are to have one done every five years.
Colonoscopy is the most thorough screening method, though some patients find it a bit too thorough. It can detect polyps (pre-cancerous growths) throughout the colon well before they turn cancerous.
Most guidelines, including the ACOG's, prefer colonoscopy because it's the most thorough screening option. It also only needs to be done every 10 years. Try doing that with your taxes. Sometimes it's better to just bite the bullet. But not all patients agree. And those who don't can choose a different screening method.
Current recommendations are that most Americans should start routine colon cancer screening at age 50, using one or a combination of the above tests and schedules. People who are at higher risk, such as those with a family history of colon cancer, may need to start screening at an earlier age or have it done more often.
Other tests, such as virtual colonoscopies and fecal DNA testing are not yet recommended for widespread use. They're too new to have a proven track record. Virtual colonoscopies are CT (x-ray) scans that are done externally.
Colon cancer is preventable but only if people get tested for it. The ACOG stresses that not enough people are being tested. Colonoscopy shouldn't be the reason. People interested in the alternatives can discuss their pros and cons with their doctor.
The ACOG report appears in the March 2011 issue of Obstetrics & Gynecology.
March 21, 2011
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