2 things you should be asking your colonoscopist
Sara Moniuszko – March 24, 2023
March is Colorectal Cancer Awareness Month — the perfect time to talk about the importance of screening for colon cancer via colonoscopies.
When you’re ready to make an appointment, did you know there are two things you can ask the colonoscopist to make sure you will be getting a thorough exam?
During a “CBS Mornings” Facebook Live hosted by CBS News chief medical correspondent Dr. Jon LaPook, gastroenterology experts discussed the quality metrics people can ask of their doctors who are doing the procedure.
First is the adenoma detection rate, or ADR, explains Dr. Mark Pochapin, head of gastroenterology and hepatology at NYU Langone Health, who was part of the discussion.
“Adenoma is a type of polyp that we find that has the potential of turning cancerous. These are the polyps we want to make sure we find and remove,” Pochapin explained. “We should be able to have a rate that is measured.”
During a colonoscopy, a long, flexible tube with a tiny camera on the end is inserted into the rectum of the patient, allowing the doctor to view the inside of the colon and remove any polyps or abnormal tissue, the Mayo Clinic explains. Since the patient is typically under sedation or anesthesia, these removals are not felt.
“Colon polyps are common in adults and are harmless in most cases. However, most colon cancer begins as a polyp, so removing polyps early helps to prevent cancer,” the National Institutes of Health says.
For patients getting their first screening colonoscopy, a physician’s ADR rate should be 25% to 30% or even higher, Pochapin says.
“I think most of us have adenoma detection rates over 40%, meaning that 40% of the time in patients getting their first screening colonoscopy, we find at least one adenoma,” he continued. He encouraged people to ask their physician about what their ADR rate is. “See if they have a response. They really should be measuring that to make sure that their quality is good.
The second thing to ask about is withdrawal time.
“If you withdraw the scope too quickly, you might miss something… it’s important that people make sure that they take their time when they’re doing the procedure,” Pochapin says.
Withdrawal time should really be around seven or eight minutes, with six minutes being the “absolute minimum” if there are no findings, he notes, adding that too long of a withdrawal time isn’t good either.
This time frame refers just to the scope withdrawal time, not the total time for the whole procedure.
“If you find a polyp, it takes time to remove that polyp… so the colonoscopy may take 40 minutes,” he explains. “You’re inserting the scope, you’re removing polyps and in addition you’re looking.”
Colorectal cancer is the third deadliest form of cancer in the United States. The American Cancer Society anticipates 153,020 new cases this year, and 52,550 deaths.
The best way to reduce your risk? Getting screened.
In 2018, the recommended age to get a first colonoscopy screening was lowered to 45 for those at average risk.
If you’re at increased risk, which includes having a family history or inflammatory bowel disease, talk to your doctor about being screened earlier.
What millennials need to know about colon cancer: Q&A with Dr. Jon LaPookColon cancer rates keep rising in younger age group, new study finds