The Top 12 13 Things to Know Before Choosing Colonoscopy   

1. Surgical removal of small colon polyps is costly and unnecessary
   
   Polypectomy (the surgical removal of polyps by colonoscopy) of small polyps found during CT colonography is costly and unnecessary according to a study performed at the University of Wisconsin School of Medicine and Public Health in Madison, WI.
   
   A decision analysis model was constructed to represent the clinical and economic consequences of performing three year colorectal cancer surveillance, immediate colonoscopy with polypectomy, or neither on patients who have 6-9 mm polyps found on CT colonography (CTC). The analysis model was accompanied by a hypothetical population of 100,000 60-year-old adults with 6- to 9-mm polyps detected at CTC screening.
   
   Results showed that, "by excluding large polyps and masses, CTC screening can place a patient in a very low risk category making colonoscopy for small polyps probably not warranted," said Perry J. Pickhardt, MD, lead author of the study. "Approximately 10,000 colonoscopy referrals would be needed for each theoretical cancer death prevented at a cost of nearly $400,000 per life-year gained. We would also expect an additional 10 perforations and probably one death related to these extra colonoscopies. There may be no net gain in terms of lives—just extra costs," said Dr. Pickhardt.
   
   "The clinical management of small polyps detected at colorectal cancer screening has provoked controversy between radiologists and gastroenterologists. Patients should be allowed to have the choice between immediate colonoscopy and imaging surveillance for one or two isolated small polyps detected at colorectal cancer screening," said Dr. Pickhardt.
   
   CT colonography is now a recommended test for colorectal cancer screening by the American Cancer Society. "If patients with small polyps are monitored, only five percent of adults undergoing CTC screening will need to undergo immediate invasive colonoscopy," said Dr. Pickhardt.
   
   Source: American Roentgen Ray Society
2. After removal of the first polyp(s), as many as 48% of the people so treated will develop a new polyp(s) and 27% will go on to develop colon cancer during the next decade
3. Even one year after the first removal, on reexamination approximately 30% of patients are found to have new polyps or older ones not detected on the first round
4. Complications from injuries sustained during colonoscopy can harm otherwise healthy patients
5. After the first cell in a polyp becomes cancerous, an average of ten years must pass before the cancer grows to a barely detectable size of about 1/2 inch
6. In almost all cases of colon cancer is far advanced by the time the cancerous growth is discovered. This means that in a significant percentage of cases the cancer cells have already spread by way of the bloodstream to other parts of the body. When cancer metastasizes in the manner, the probability that it will eventually kill its victim is vastly increased
7. Colon cancer is found most frequently in wealthy countries, where people eat rich foods consisting predominantly of red meats, dairy foods, rancid vegetable oils, processed foods, white bread and other refined grains. On the other hand, people following diets providing plentiful amounts of whole grains, vegetables, legumes, and fruits and very little in the way of meats and dairy products develop few cases of colon cancer....MY DIET. In fact, if a person is physically active, have a normal 2-3 bowel movements daily, follows a low fat, high fiber diet, and have no symptoms, the practice of routine colonoscopy or sigmoidoscopy should not be considered necessary...MY LIFESTYLE...MY VIEW...MY PERSONAL CHOICE
8. Certain vegetables such as broccoli, cauliflower, garlic, onions, bok choy, brussel sprouts, turnips and leafy greens - causes the colon's cells to secrete enzymes that inactivate many carcinogens. BTW, chlorinated water is also associated with a higher incidence of colon and rectal cancers...I choose to avoid chlorine
9. The current 5 year survival rate (all stages) per conventional colon cancer treatment is approximately 61%. Most Americans believe this is closer to 100% based on medical propaganda and bias
10. Jerome J. DeCosse, MD, PhD, and colleagues at the University of Wisconsin's Department of Surgery and pathology discovered that when vitamin C was added to the treatment protocol of polyp sufferers, polyps were either reduced in number or completely eliminated in five out of eight people...I RECOMMEND AND TAKE VITAMIN C DAILY
11. Scientific studies have indicated that high levels of vitamin D may reduce the risk of getting colon cancer by 51%. Therefore make sure regular exposure to sunlight before, 10:00 a.m. and after 3:00 p.m. is a part of you health regimen. Vitamin D supplementation is another excellent choice.
12. Former presidential press secretary and media commentator Tony Snow died of complication due to colon cancer and medical intervention. Because Mr. Snow had a family history of colon cancer he had a colonoscopy exam at least every six months. Mr. Snow was told repeatable by his medical doctor that he did not have colon cancer. Unfortunately, the colon cancer that he went on to be diagnosed with existed for a number of years until it was finally discovered. Mr. Snow’s case should serve to illustrate that having colonoscopies does not guarantee or insure that one is free of cancer.
13. Nearly two-thirds of hospitals fail to check colon cancer patients well enough for signs that their tumour is spreading, says a study of nearly 1,300 hospitals, and it was found that overall, just 38 per cent fully comply with the guideline, Northwestern University researchers report in the Journal of the National Cancer Institute. 9/10/08

In closing, the core of my personal decision to not have a colonoscopy is, understanding risks versus benefits, living the way I live, and believing what I know to be truth. However, my personal views should not preclude any individual from having the right to chose to have any medical procedure including colonoscopy.

All my best,

Dr. Bob Martin