Which cancer treatment is not recognized
Women and men are entitled to two colonoscopies for the early detection of colon cancer. If the first colonoscopy shows an inconspicuous finding, a new examination is usually only necessary after ten years. Men can have a colonoscopy from the age of 50, women from the age of 55. Those who only take advantage of the offer at the age of 65 or later are only entitled to this one colonoscopy.
Before the doctor can examine the bowel, it must be thoroughly cleaned. Therefore, you must take a laxative the day before the examination and drink a lot, preferably water, unsweetened tea or broth. Although this preparation is a bit uncomfortable and exhausting, it is necessary because the intestinal mucosa must be clean so that the doctor can assess it properly.
If you wish, you can be given a sedative before the examination that will put you into a kind of twilight sleep. Then you will hardly notice anything from the colonoscopy. However, because the sedative works longer, you must follow a few rules for your own safety afterwards (for example, do not drive home). Let your doctor explain this to you. It is also good if someone can accompany you to the examination.
In a colonoscopy, the doctor pushes a thin, flexible tube (endoscope) containing a light source and a camera from the anus through the rectum and colon to the transition to the small intestine. Then he slowly pulls back the tube and looks closely at the intestinal lining. So that he has a better view, the bowel is widened with a little air. If any preliminary stages of colon cancer are found, the doctor removes them with a snare or small forceps during the examination. This method has the advantage that cancer and colon cancer precursors can be detected with a high degree of accuracy.
Colonoscopy as part of early cancer detection
Out of 1,000 colonoscopies performed as part of early cancer detection, 203 are
• Colon cancer is found in 9 of these 203 people (the colonoscopy is true positive).
• The remaining 194 people have one or more adenomas. These adenomas advanced in 64 of the 194 people.
In 797 out of 1,000 people examined, neither colon cancer nor adenoma is found (the colonoscopy is true negative).
Colonoscopy detects around 95 out of 100 actual colon cancers.
The figures make it clear that there is a difference between the stool test and the colonoscopy. This is because not every colon cancer or adenoma sheds blood into the stool.
It is not yet known exactly how many deaths from colon cancer can ultimately be prevented by a colonoscopy. However, meaningful studies have shown that the so-called small colonoscopy (rectosigmoidoscopy), in which only the rectum and part of the colon are examined, 2 in 1,000 people examined fewer die of colon cancer.
Since the stool blood test also reduces the death rate from colon cancer and the colonoscopy is a measure that goes beyond that, experts believe that the effectiveness of the colonoscopy is even greater. Data also shows that removing adenomas can, in most cases, prevent colon cancer from developing.
• A colonoscopy is a relatively safe way to detect colon cancer early.
• Pre-stages of colon cancer, which often go undetected in stool tests, are discovered.
• These precursors are removed during the colonoscopy. In most cases, this will prevent them from developing into cancer later on.
Risks and Side Effects
• In order to be able to adequately assess the mucous membrane during the colonoscopy, you must clean the colon very well. You may find this uncomfortable.
• If you were given a sedative before the examination, there are a few rules to follow for your safety afterwards.
• You may need to overcome a certain sense of shame for the examination.
• Complications are found in 2.8 out of 1,000 colonoscopies and severe complications in 0.6 out of 1,000. The most common complication is bleeding, which occurs in 1.5 out of 1,000 examinations. They usually arise when polyps are removed. They can usually be breast-fed during the procedure. The patient only has to go to hospital for every eighth bleeding. Injuries to the intestinal wall (perforations) occur in 0.2 out of 1,000 people examined, so they are relatively rare. In isolated cases people have died after the perforation. 0.6 out of 1,000 people examined have problems with the heart, circulation or breathing.
That is what the German Cancer Aid recommends
From the point of view of the German Cancer Aid, according to all the data available so far, colonoscopy for early detection of colon cancer makes sense for men aged 50 and over and women aged 55 and over. The German Cancer Aid assesses the possible risks and side effects of colonoscopy as low compared to the advantages of early detection of colon cancer.
For people with a hereditary predisposition to colon cancer, a special and more closely meshed early detection program makes sense in addition to organized colon cancer screening. Anyone who thinks they have a family history can get information and advice from a center for familial colon cancer.
Other testing procedures, which are currently offered by some doctors as individual health services (IGeL) and which you have to pay for yourself, are not recommended for various reasons. These include: genetic stool tests, determination of M2-PK (enzyme stool test), computed tomographic (CT) colonography, capsule endoscopy.
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