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EDITORIAL: A day of discomfort can result in a healthier, longer life

Reading Eagle, Pa.


March 09--The Issue: Two studies prove colonoscopies save lives.

Our Opinion: Yes, the preparation is unpleasant, but the alternative can be much worse.

For years doctors have been telling their patients that a colonoscopy is an effective way to prevent the onset of colorectal cancer, but they really had nothing more than anecdotal evidence to support their claims, until now.

Two studies, one done at the Memorial Sloan-Kettering Cancer Center in New York and one done in Spain, indicated the procedure is more effective than other diagnostic tests in spotting growths that can be removed before they become cancerous, resulting in longer lives of those who undergo the less-than-pleasant operation.

The results of both studies were reported in the New England Journal of Medicine last week.

Doctors sometimes have had a difficult time convincing their patients to undergo a colonoscopy because of the need for a modified diet and solutions a day before the test to clear out the bowel.

"Sure, it's a pain in the neck," Dr. Sidney Winawer, a leader of the study at Sloan-Kettering, told The Associated Press. "People complain to me all the time. It's horrible. It's terrible. But look at the alternative."

The alternative is a stool test, which is far-less uncomfortable, but the Spanish study, conducted on 53,000 participants, indicated it was far-less effective in detecting problems. Colonoscopies found advanced growths in twice as many people, 514 versus 231, and precancerous polyps in 10 times more people.

There can be little doubt about the need for some type of screening process to detect colorectal cancer. According to the American Cancer Society, it is the second leading cause of cancer death in the United States, behind only lung cancer, and the fourth worldwide. More than 143,000 new cases are expected in this country in 2012, and nearly 52,000 people are expected to die from it this year.

But thanks in large part to the fact that doctors have been able to convince a growing number of their patients to undergo regular colonoscopies, the incidents of deaths from colorectal cancer have been declining for the last two decades.

The American Cancer Society recommends that adults without a family history of colorectal cancer get their first colonoscopy at the age of 50 and have the test repeated once every 10 years as long as no polyps are found. If polyps are discovered, the test should be repeated every five years.

Those adults with a family history of colorectal cancer should consult with their physicians as to when to begin colonoscopies, but age 40 usually is considered a good starting point.

Perhaps it shouldn't be surprising, considering the unpleasantness involved in the colonoscopy, that two-thirds of the people in both studies opted against undergoing the procedure. But the test results show that enduring such short-term discomfort by taking the test can go a long way to prevent long-term agony and premature death.

For Pennsylvania residents, the cost of the diagnostic procedure should not be a factor. In 2008 Gov. Ed Rendell signed into law a bill requiring health-insurance companies to cover the costs of colonoscopies, which run about $1,000. But even if insurance wouldn't cover the test, it is far more expensive to treat cancer.

If you are 50 or older, follow the cancer society guidelines for testing. The life you save would be your own.


(c)2012 the Reading Eagle (Reading, Pa.)

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