Recently, there has been quite a controversy regarding two different colon cancer screening methods. Patients are asking whether a colonoscopy or sigmoidoscopy is better, and doctors just can’t seem to make up their minds.
First, let’s talk about the procedures themselves.
A colonoscopy involves inserted a lighted tube into the colon through the anus. A video camera is attached to the tube, allowing the doctor to see the entire length of the colon .
A sigmoidoscopy, on the other hand, involves using a sigmoidoscope which is inserted into the colon through the anus, allowing the doctor to search the inside of the rectum and the first third of the colon .
The main difference seems clear: Colonoscopies screen the entire colon, and sigmoidoscopies only screen a third of it. But why is it that doctors have such differing views about which of the procedures works best?
In a recent article on Boston.com, Dr. John Abramson discussed why he believes that a colonoscopy isn’t the best way to screen for colon cancer. He stated that while colonoscopies allow the doctor to see more of the colon, this fact doesn’t necessarily “translate into a reduction in the incidence and mortality from cancer that is beyond the reach of a flexible sigmoidoscope .”
Furthermore, Abramson pointed out that while sigmoidoscopies must be repeated every five years, it still has many benefits including an easier preparation process, a lower price tag and its lower risks since it doesn’t require anesthesia, unlike colonoscopies.
Boston.com spoke with another doctor, who disagreed with Abramson. Dr. John Saltzman, the director of endoscopy at Brigham and Women’s Hospital, stands behind colonoscopies and believes they are the best way to screen for colon cancer.
“While sigmoidoscopy is cheaper and relatively quick, it has several significant disadvantages,” Saltzman stated. “It does not use sedation and can be an uncomfortable examination; what’s more, it only examines the bottom third of the colon, missing about half of the significant precancerous polyps and cancers.” He went on to point out that colonoscopies permit doctors to both examine the colon as well as remove any detected polyps in one session.
Until the medical community can come to agreement, there is one thing that they can agree on: any examination is better than none, especially once you hit the age of 50. If you have a personal history of colon cancer in your family, you’ll want to get checked earlier and more frequently. It would be wise to talk to your physician about what would be best for you.
-Dr. Edward F. Group III, DC, ND, DACBN, DABFM
- National Digestive Diseases Informaiton Clearinghouse. Colonoscopy. NIH Publication No. 10-4331. 2010 January.
- National Digestive Diseases Informaiton Clearinghouse. Flexible: Sigmoidoscopy. NIH Publication No. 09-4332. 2008 November.
- Deborah Kotz. Experts debate: what’s the best way to screen for colon cancer? Boston.com. 2011 March 24.
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