Colonoscopy can save lives – who should definitely do it

Fewer and fewer people are dying of colorectal cancer. Those affected owe this to preventive medical check-ups, above all the colonoscopy. But experts say many more cases can be prevented. Especially among young people.

Thousands of deaths from colon cancer could be prevented through prevention

Around 3,000 people under the age of 50 are currently diagnosed with colon cancer in Germany every year. This was recently pointed out by Hermann Brenner, head of the Department of Clinical Epidemiology and Aging Research at the German Cancer Research Center (DKFZ) at the specialist symposium “Colon cancer prevention 3.0”. network against colorectal cancer.

According to this, around 60,000 people still fall ill every year, and around 25,000 die. However, the doctor assumes that these numbers could be halved within the next ten years alone. After all, if cancer is detected early, it can usually be cured. For example, the precursors of cancer can be removed during a colonoscopy. The check-up can save lives – FOCUS online clarifies the most important questions. The Felix Burda Foundation lists these on their website:

From what age should I go for colorectal cancer screening?

From the age of 50 if there is no increased risk. From this age onwards, health insurance pays for screening colonoscopy for men and a stool test for women, which can be used to detect hidden traces of blood in the stool. These can be a sign of polyps or carcinoma. From the age of 55, women are entitled to a colonoscopy.

If there is an increased risk due to a family history of colon cancer or a chronic inflammatory bowel disease, you should have a colonoscopy much earlier, at the latest by the age of 40 to 45 if there is a family history of colon cancer.

Are there any symptoms of colon cancer?

Symptoms of colorectal cancer often only appear when the disease is already well advanced. However, it is advisable to consult a doctor for all long-lasting problems in the digestive tract. The specialist in examinations of the digestive tract is the gastroenterologist. He will decide with you which examinations should be carried out to clarify your symptoms.
Symptoms that make a colonoscopy necessary are, for example:

• visible blood in the stool
• Noticeable changes in bowel habits such as alternating diarrhea and constipation
• persistent abdominal pain

How do I know if I have family burdens?

In about 30 percent of colon cancer cases, colon carcinomas and colon polyps have already occurred in other family members. This means for all direct relatives of those affected – that is parents, siblings and children – that they have an increased risk of colorectal cancer. Just having a direct relative with colon cancer increases your risk of developing the disease by two to three times. If you have a family burden, you should have a colonoscopy performed at an early stage. A stool test is then definitely not recommended because it does not detect all polyps and carcinomas that are present.

Is the colonoscopy painful?

Your doctor will offer you an injection that will put you into a short twilight sleep. You will then sleep through the examination in the truest sense of the word. The entire examination takes no longer than about 20 minutes.

Is a stool test by my family doctor not sufficient for screening?

The test for hidden blood in the stool does not guarantee that a carcinoma or polyps may not have formed in your intestines. The test will only show traces of blood if existing tumors and polyps are bleeding, which they do not always do. For this reason, it is also recommended to repeat the test every year. If a test was positive, the cause must be clarified by a colonoscopy. This is the most effective preventive method, as it can be used to identify the benign precursors of colon cancer (polyps). Removing the precursors prevents the polyps from later degenerating into cancer.

Can the intestine be injured during the examination?

In the hands of an experienced doctor, the colonoscopy is a very safe and gentle examination method. However, complications can occur in exceptional cases.

How often should I go for a colonoscopy?

Normally, the recommendations of the statutory health insurance companies are sufficient: first preventive colonoscopy for men at the age of 50 for women at the age of 55, repeat after ten years in the case of a colonoscopy without findings. It is different in the case of an increased risk. Individual recommendations apply here, which you should discuss with your doctor.

Can I work after the examination?

Without the twilight injection you are fully able to work after a colonoscopy. If, on the other hand, you take advantage of the short anesthetic that is offered, you will not be able to go back to work immediately afterwards. They are also not allowed to drive and are asked to have an accompanying person pick them up from the practice if possible.

If I am found to have a polyp, how will it be removed?

The polyps detected during the colonoscopy are removed during the examination. The intestine is insensitive to pain, so the procedure does not cause pain. A fine wire loop is advanced through the working channel of the endoscope, placed around the polyp and tightened. A high-frequency current is passed through the wire loop for a brief moment. The heat causes the polyp to be cut off and the blood vessels to be closed. The cut polyp is then pulled out of the intestine along with the endoscope. The polyp is then sent to the laboratory for histological examination. There it is analyzed whether cancer cells were already present and whether the polyp could be completely removed.

What if it really is cancer?

With the colonoscopy, benign precursors of colon cancer can be detected and removed. In most cases, cancer that is already present is detected so early in the preventive colonoscopy that it can be completely cured.

If cancer is suspected or confirmed in the laboratory, there are also a number of other examination methods to determine the exact spread of the disease. Several doctors are often involved in this, for example

• Gastroenterologist (gastrointestinal specialist),
• Radiologists (doctor specializing in imaging procedures) and
• Oncologists (cancer specialists).

In most cases of colorectal cancer, the operation of the colorectal tumor is an important step in the treatment. The subsequent, histological examination of the tumor tissue completes the diagnosis with regard to the stage of the disease and the growth behavior of the tumour. This information flows into the further planning of cancer therapy.

Chemotherapy is also part of the treatment for many patients. Patients with rectal cancer often also receive radiation. If metastases have already developed, it is possible to use so-called targeted drugs in addition to chemotherapeutic agents. Immunotherapy is currently also being intensively researched for colorectal cancer.

Who pays for the colonoscopy?

Since the preventive colonoscopy is a statutory service, you will not incur any costs. Men are entitled to this examination from their 50th birthday, women from their 55th birthday and can repeat it free of charge after 10 years.

Note: The Felix Burda Foundation, like FOCUS online, belongs to Hubert Burda Media.