By DR. GIFFORD-JONES
"Why in the name of heaven do I submit to this procedure every five years? To be forced into such an undignified position makes me wonder each time if there's a God."
This is a question I'm frequently asked, and my answer remains conclusively the same. I'd rather face 15 minutes of immodesty to months of dying slowly from cancer of the large bowel. So don't be fooled by a recent newspaper headline stating that colonoscopy isn't 100% foolproof. If you use this report as an excuse for not lying on the colonoscopy table, you could be making be a fatal error.
The gold standard for diagnosing colon cancer has always been colonoscopy. But scientists at The Institute for Clinical Evaluative Sciences and the universities of Toronto and Western Ontario recently reported a study showing colonoscopy failed to diagnose cancer in 4% of cases. So what does this mean?
It emphasizes once again there are only two things for sure in this life -- death and taxes. Rockets costing millions designed by world-class scientists sometimes blow up. It follows that procedures done by lesser mortals always have an element of error. Why does this happen in colonoscopy, and how can the batting average be improved? There are a few basic rules.
- Doctors cannot diagnose what they can't see. To diagnose colon polyps a video colonoscope is inserted into the large bowel. This sends a colour picture from inside the colon back to a TV screen. But to see polyps the bowel must be 100% clean. If patients don't take laxatives followed by copious amounts of water, prior to the exam, particles of fecal matter can hide polyps.
- Practice makes perfect whether you're designing rockets or performing colonoscopy. There are more doctors available to do this procedure. But no doubt some missed polyps are due to doctors who are less skilled.
- The more doctors look the more they see.
If doctors try to rush through this procedure, it increases the chance of error. So it's prudent to not keep asking the doctor "How much longer will it take?"
