Michael Margolin, MD, FACP, FACG  
     
     
PREVENTING COLON CANCER WITH COLONOSCOPY
 
  Medicare and most insurers will pay for colon and rectal cancer screening after age 50, and at a younger age for patients at high risk or having symptoms. Cancer of the colon and rectum is the nation's second leading cancer killer. Recent studies have shown that finding and removing pre-cancer growths, called polyps, at colonoscopy can prevent most colorectal cancers from even starting. In addition, when screening tests find cancers in people without any symptoms, these people are more likely to be cured than had testing been delayed until symptoms developed. In spite of this, 60% of Americans over age 50 have not had any screening for this disease.   The American Cancer Society and the American College of Gastroenterology recommend that colorectal cancer screening start at age 50 in people at average risk for the disease. People with a family history of colorectal cancer or polyps in a close relative, and people with ulcerative colitis or Crohn's disease of the colon are at higher risk for developing colorectal cancer and may need to start screening tests at an earlier age and have more frequent follow-up. The Harvard Medical Letter and many cancer experts now recommend universal colonoscopy for everyone over age 50. Medicare will pay for screening colonoscopy every 10 years in all people with Medicare over age 50, even if they have no symptoms and no increased risk of colon cancer. Many other insurance companies are offering similar coverage.    

I perform most Colonoscopy procedures in a specialized outpatient center, Garden State Endoscopy & Surgery Center in Kenilworth using High Definition scopes (rarely insurance or other needs require that the procedure be done at Overlook or Trinitas Hospitals' outpatient departments).  After a sedative is given to keep the patient entirely comfortable, I pass a flexible tube with a video camera on the tip into the rectum and then thread it through the entire colon. If a polyp is found, I expect to remove it at that time. Early removal of a polyp prevents it progressing into a cancer.