Colonoscopy can be a lifesaver

Dear Dr. Gott: Please speak to the effectiveness of the sigmoidoscopy versus the colonoscopy in detecting disease. My primary care physician performs a sigmoidoscopy every year as part of my annual physical. Is this necessary or a waste of medical resources? I have had only one colonoscopy, three years ago at age 63, with negative results.

Dear Reader: Most authorities would agree that the sigmoid exam is a waste of time, money and resources.

The flexible sigmoidoscopy is simple, relatively safe and – until recently – was the preferred screening for bowel cancer. The problem? It enabled the physician to view only one-third of the colon – specifically, the descending colon.

Neither the transverse colon nor the ascending colon could be examined by this method; therefore, two-thirds of the large intestine was not examined, hardly a comforting fact.

When medical studies began endorsing colonoscopy as the preferred method of testing, I scanned my files and discovered that in two years of sigmoidoscopy, I had four patients with advanced cancer of the ascending colon.

I got the message. Colonoscopy, despite its nuisance in preparation and its discomfort, is well worth the inconvenience.

I encourage all of my patients 60 and older to have this exam. It may be lifesaving. Colon cancer, if discovered early, is curable.

In your case, a colon study every five to 10 years should suffice. Additional sigmoid exams would be repetitive and unnecessary.