Division of Gastroenterolgy and Digestive Disorders

Three Questions to ask before a Colonoscopy

People who are considering a colonoscopy should ask the physician three questions to ensure they have the safest and most effective screening for colorectal cancer.

“Too many patients are so focused on their concerns about the colonoscopy, know too little about the procedure, or are too worried about offending their physician that they don’t ask questions about the physician’s experience,” said Dr. Charles Bongiorno, chief of the Division of Gastroenterology at the UMDNJ-School of Osteopathic Medicine. “In reality, these are legitimate questions that the physician should be able to answer easily. If your physician can’t or won’t answer, it’s time to find another physician.”

Dr. Bongiorno says that everyone should ask these questions before agreeing to the procedure:

What percentage of patients have polyps discovered during a colonoscopy? Polyps are small, grape like growths on the lining of the colon or rectum that can turn cancerous. Statistics indicate that during routine screening colonoscopies, physician, on average, should find polyps in about 25 percent of men and 15 percent of women.

What is the physician’s perforation rate? One of the risks of colonoscopy is the chance that the physician will accidentally perforate the lining of the bowel during the examination. At the minimum, the physician should have had fewer than one case of perforation for every 500 procedures. Ideally, this rate will be less than one in 1,000.

What is the physician’s standard withdrawal time during a colonoscopy? Because polyps sometimes are hidden behind folds in the colon, they are actually easier to spot as the colonoscope is being withdrawn because that is when the colon is the most dilated. The U.S. Multi-Society Task Force on Colorectal Cancer recommends a minimum of six minutes withdrawal time to ensure a high quality colonoscopy.

The American Cancer Society recommends that men and women who are at normal risk for colorectal cancer should have a colonoscopy every 10 years beginning at age 50. Colorectal cancer is the third most common cancer and the second leading cause of cancer deaths in America.