Colonoscopy

What To Think About

• In general, pregnant women or people who have severe heart disease, an abdominal infection, or diverticulitis should not have a colonoscopy unless there is an important reason for it.
• Colonoscopy is a more expensive procedure than a barium enema and other endoscopic colon tests (such as proctoscopy or sigmoidoscopy), but it can be done less often over time if results are normal. Colonoscopy is recommended every:
  • 10 years for people with normal results.
  • 3 to 5 years for people with increased risk factors for colorectal cancer or when problems are found during the colonoscopy.
• Most experts, including the Canadian Association of Gastroenterology (CAG) and the Canadian Digestive Health Foundation (CDHF), recommend that people with no risk factors for colorectal cancer start screening tests at age 50. Fecal occult blood testing (FOBT) or a sigmoidoscopy test may be recommended or a colonoscopy or double-contrast barium enema (DCBE) may be used. If results from FOBT or sigmoidoscopy show a problem, a follow-up colonoscopy is recommended. For more information, see the medical tests Fecal Occult Blood Test, Sigmoidoscopy, and Barium Enema.
• The CAG and CDHF recommend that people with risk factors for colorectal cancer start screening tests at age 40. Tests may include FOBT, sigmoidoscopy, barium enema, or colonoscopy. If you are at increased risk of colon cancer, talk to your doctor about which test is best for you and how often you should do the tests.
• Talk to your doctor if you are considering virtual colonoscopy to screen for colon cancer. This procedure is a newer method that uses a CT scan to take two- or three-dimensional pictures of the colon. In Canada, this procedure is currently available only at a few specialized medical centres.
  • Virtual colonoscopy is less uncomfortable than standard colonoscopy and may be a good test for people with an average risk for colon cancer. However, if you have a virtual colonoscopy and a problem is found, you may need a standard colonoscopy so a biopsy can be done. Virtual colonoscopy may not find small colon polyps as well as a standard colonoscopy.
  • For people with a risk for colon cancer, standard colonoscopy may be a better choice because a biopsy can be done or a polyp can be taken out.
  • Virtual colonoscopy may not be covered by your provincial health insurance plan. Check with your provincial health plan before having the test.
  • Virtual colonoscopy uses the same colon prep as colonoscopy. For many people, the prep for a colonoscopy is more bothersome than the actual test.

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Author:	Douglas Dana Jan Nissl, RN, BS	Last Updated: October 23, 2006
Medical Review:	Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
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