Here’s some uncomfortable good news: Colonoscopies really do save lives.

Doctors at Memorial Sloan-Kettering Cancer Institute in New York City tracked 2,602 patients who had colonoscopies between 1980 and 1990. In follow-up studies, done 16 years after the procedure, they found that 12 had died of colon cancer, while the normal mortality from the disease for a group that size would be 25.4. That’s a reduction in colon cancer deaths of 53 percent.

In the words of Robert A. Smith, senior director of cancer control at the American Cancer Society, “This is a really big deal.”

The society estimates that 51,000 people will die of colorectal cancer in the United States this year, and 143,000 new cases will be diagnosed. The disease is easily curable if detected in time, but barely half of adults are up to date on screenings that normally start at age 50. If a person’s test is normal and there is no family history of the disease, a screening is not repeated for another 10 years.

The colonoscopy, however, may be one of the least popular, and thus most avoided, of the common medical screenings. A thin probe with a miniature TV camera and a pair of snippers is inserted into the rectum and wiggled deep into the intestines. Any polyps encountered along the way are snipped and biopsied.

Not all polyps are cancerous, but all colorectal cancers start as polyps.

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The procedure is preceded by an insipid diet of clear liquids and the consumption of several quarts of a cleansing laxative. The flavor packs that come with it do little to help.

The patient can follow the entire procedure on a TV monitor and, one supposes, if the patient has a strong enough imagination, can believe he is watching the Nature Channel or the 1966 sci-fi flick “Fantastic Voyage.”

Until this study, there had never been truly definitive proof that colonoscopies worked, leaving just enough doubt so that the squeamish could rationalize opting out. Not now.

One doctor counsels wavering patients: “You’ll feel really stupid if you die of colon cancer.” A little humiliation and discomfort are a small price to pay to be smart and alive.

Editorial by Dale McFeatters, Scripps Howard News Service


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