Getting a screening colonoscopy can detect cancer early when it’s more treatable. That’s why colonoscopies are considered the gold standard for detection. But a new study discovered that the experience and skill of the gastroenterologist who performs the procedure can affect your risk of being diagnosed with colon cancer or dying from the disease.
The focus of the Kaiser Permanente study, published in The Journal of the American Medical Association, was to find out what effect the physician’s skill at finding pre-cancerous polyps known as adenomas had on patients’ lifetime risk of developing and dying from colon cancer. Finding and removing these polyps prevents them from becoming cancerous.
Previous studies had discovered that adenoma detection rates varied among physicians and that higher rates were associated with a lower risk of dying from colon cancer. The new study examined data from more than 57,000 patients in Northern California who underwent colonoscopies performed by 136 Kaiser Permanente doctors between 1998 and 2010.
The patients of the physicians with higher adenoma detection rates had a 13 percent lifetime risk of colon cancer. Those whose physicians who had the lowest detection rates had a 27 percent lifetime risk, which is only seven percent lower than people who never underwent the screening. The researchers also noted that higher detection rates did not translate into higher overall costs to the healthcare system.
How do you find a skilled physician to perform your colonoscopy?
Currently, it can be difficult to find out what a physician’s adenoma detection rate is because that data is not collected by most hospitals and gastroenterology practices. There are several questions you can ask, however, that can help you find an experienced, skilled physician to perform your screening.
- What training have you had in performing colonoscopies? Are you board certified? The American Society for Gastrointestinal Endoscopy has developed a core curriculum for performing colonoscopies and polyp removal as well as specialized, advanced training for performing colonoscopies in more complex situations.
- How many colonoscopies do you perform a week? Five per week is a good baseline.
- Do you have information on how often you find polyps during the procedure? If the physician gathers this data, he or she should detect polyps between 15 and 25 percent of the time in a general screening population.
- How often do you complete a full exam of the colon? More experienced physicians are better able to move the scope past the beginning of the large intestine and get a view of all of the areas where there may be polyps or tumors. A skilled physician should be able to do this 90 percent of the time when the patient has properly prepared his or her bowel.
- How long do you take withdrawing the scope from the colon on average? The process should take no less than six minutes or the physician risks missing polyps.
For additional help finding a physician with the expertise needed to perform a higher quality colonoscopy, you can talk with a personal health advisor. An advisor can also help you make sure you stay current with all appropriate health screenings and preventive care to live your healthiest life.