Five Reasons NOT to Get a Colonoscopy

A clinician points to an image of intestines

Key Takeaways:

  • Many people avoid colonoscopies due to misconceptions, but colorectal cancer affects over 150,000 Americans annually, with 85% having no family history.
  • Insurance typically covers colonoscopies, with recommended screenings starting at age 45 and repeating every 10 years for average-risk individuals.
  • Despite past unpleasant experiences, advancements have made colonoscopy preparations more tolerable, offering a crucial opportunity to prevent colorectal cancer, which is highly treatable if detected early.

You know how it is. You probably have passed a sign or a billboard reminding you that March is colorectal cancer awareness month. And next month is national sprained ankle month, or whatever it is. Roll your eyes and move on, right?

So – to make sure we don’t bore you with yet another finger-wagging admonishment to schedule your colorectal cancer screening, we have instead decided to share the Top Five Reasons NOT to Get a Colonoscopy.

The top reasons – and the reality behind each – come from the experience of the doctors within our Colorectal Surgery Program at NewYork-Presbyterian/Columbia University Irving Medical Center. They know – they've heard them all.

  1. No one in my family has had colorectal cancer, so I don’t need a screening.
    Reality: About 150,000 Americans develop colorectal cancer each year, making it the third most common cancer-related cause of death in the U.S. 85% of these patients have no family history of the disease.
  2. My insurance won’t pay for a colonoscopy.
    Reality: Almost all insurance plans do pay for screening at the correct intervals. For people at average risk, with no known risk factors, the first colonoscopy should occur at age 45, and then every 10 years thereafter, if the previous results were normal.
  3. The wait is too long to get an appointment.
    Reality: Anyone can call our colorectal experts at (212) 342-1155 to book an appointment without a long wait. NYP/Columbia offers screening at multiple convenient locations.
  4. The preparation is too unpleasant. I can’t drink that awful-tasting stuff, and I don’t want to have to spend the evening running to the toilet.
    Reality: If you had a colonoscopy ten or more years ago, your memory serves you correctly, because the preparation was rather unpleasant, we admit. Today, however, patients are given just two liters in what is called Low Volume Preparation – this is half of what was used in the past to clean out before a colonoscopy.
  5. Colorectal cancer is so uncommon. Why do we have to go looking for it?
    Reality: Almost all colorectal cancers begin as a small polyp. If a polyp is found during colonoscopy, it will be removed and this prevents the polyp from every turning into cancer. But if you don’t have your colonoscopy in the first place, then you are throwing away the chance to detect polyps when they are easily treated.

You may wonder, if colorectal cancer is the most preventable cancer, then why is it the third leading cancer-related cause of death in our country? The simple answer: not enough people are having colonoscopies. According to our doctors, “Almost all patients who get colorectal cancer do so because they have failed to get screenings. Almost all the colorectal cancers would be prevented if people had their recommended screenings.”

Alas, it’s not a sexy topic, but we hope this has given you a little nudge in the right direction. In case you missed it, here is the number to call: (212) 342-1155.

Need-to-Know Facts about Colorectal Cancer

  • Colorectal cancer is directly related to age. As baby boomers approach their 70s and 80s, a significant increase in colorectal cancer is expected to occur.
  • Colon cancer is preventable in nearly all cases through proper screening by removing polyps.
  • Polyps may take five to ten years to become malignant.
  • Begin screening at age 45, then every 10 years thereafter unless you have risk factors for colorectal cancer.
  • Conditions that increase the risk for colorectal cancer include ulcerative colitis, Crohn’s disease, inflammatory bowel disease, and familial cancer syndromes such as HNPCC.
  • If a first-degree relative (parent, sibling, child) has colorectal cancer, you are at higher risk.



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