What is the difference between colon cancer prevention and colon cancer screening?
All colon cancers start out as benign pre-cancerous polyps. Colonoscopy is the only screening test that prevents colon cancer because any pre-cancerous polyps detected during the procedure are easily removed. Approximately one out of four people have pre-cancerous polyps.1 The polyp detection rate, referred to as the adenoma detection rate (ADR), varies by gender and GI doctor. The current national ADR targets for quality are a minimum of 30% for males and 20% for females (average ADR of 25%). The current ADR rate at Spokane Digestive is approximately 41.5%.
Stool testing for colorectal cancer screening remains a popular concept for many individuals, as it is relatively easy and non-invasive. Stool testing includes Fecal Occult blood test (FOBT), Fecal Immunochemical Test (FIT), and multi-targeted stool DNA testing (e.g. Cologuard®). The objective of stool testing is to detect colon cancers and pre-cancerous polyps early. All positive stool tests will require a follow-up colonoscopy.
A colonoscopy is the most accurate screening test. Compared to colonoscopy, studies have shown a single Cologuard® stool test accurately identified 92 of every 100 colon cancers. This was better than the FIT stool test which only picked up 73 of 100. Cologuard® detected 42 of 100 pre-cancerous polyps (missed 58). The FIT stool test detected 23 of 100 pre-cancerous polyps (missed 77).2
Seventy percent of colon cancer arises in people without any family history of colon cancer. Patients who are 50 or over should be screened. Screening is recommended at age 45 for African Americans. The trend is for health plans to cover screenings at an earlier age, so check your insurance benefit. If you have a family history of colon polyps or cancer, colonoscopy may be recommended beginning at age 40 or younger. If you’ve ever had colorectal polyps or cancer, your doctor will recommend how often you should repeat colonoscopy.3
Colorectal cancer screening is covered as a preventative benefit by most health insurers resulting in no patient out-of-pocket costs. A follow-up colonoscopy required by a positive stool test result will be considered “diagnostic.” A diagnostic colonoscopy typically requires the patient to pay out-of-pocket, because the charge is subject to the patient’s co-insurance and deductible limits. The average cost for a colonoscopy in Spokane ranges from approximately $900 to $2,500. Spokane Digestive’s average cost is $1,045 according to www.wahealthcarecompare.com an independent site that tracks actual claims paid.
Colonoscopy is not painful. Advances in colonoscopy including lower volume preparations, Propofol anesthesia, and carbon dioxide for insufflation of the colon, have made colonoscopy safe with faster recovery times and less patient discomfort.
Quick procedure to perform—usually 30 minutes.
Patient discomfort is minimal with this procedure.
Entire colon and rectum will be examined.
If found, remove polyps and perform a biopsy.
We understand patients are anxious and nervous, and may be embarrassed to take off their clothes and show their body. We provide colonoscopy in a safe environment with compassion and kindness. We will make you comfortable, keep you draped, and preserve your dignity while you’re in our center.
We have high quality. We measure our quality against national standards and our quality exceeds national benchmarks. Spokane Digestive’s ADR is 41.5%.
We are a great value—high quality and low cost. Colonoscopy performed in our center is less than half the cost of the same procedure performed in an outpatient hospital environment.
Unlike many hospital outpatient departments, our endoscopy center generally runs on time so most patients are here approximately two hours from check-in until discharge.
We’ve been taking care of patients in Spokane and serving the region since 1978.
1 This information is based on the document Quality Indicators for Colonoscopy, a product of the ASGE/ACG Task Force on Quality in Endoscopy. The polyp detection rate, referred to as the adenoma detection rate (ADR), varies by gender and endoscopist. The current national ADR targets for quality are a minimum of 30% for males and 20% for females (average ADR of 25%). The current ADR rate at Spokane Digestive is approximately 41.5%.
2 Cologuard® product disclosures (Exact Sciences Corporation).
3 Colorectal Cancer Screening: Recommendations for physicians and patients from the U.S. Multi-Society Task Force on Colorectal Cancer, July 2017.