Colonoscopy frequency for third time?

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I am 56 years old and have had 2 colonoscopies. The first was when I was 51 and 4 small polyps were removed in the 2 to 5 mm range that were listed as having features suggestive of sessile serrated polyp. There was also a 5 mm polyp with overlapping features of sessile serrated and hyperplastic polyp removed from the ascending colon. I had a second colonoscopy 2 years later at 53 and and 2 polyps were removed 1-2mm and listed as polypoid mucosal excrescence with a stromal lymphoid aggregate.

My gi doctor is suggesting I get another colonoscopy this year which will be 3 years after the second colonoscopy. I am trying to decide whether to go ahead with it or delay for a year or 2. I have read some of the tables for surveillance and seems like it can range from 3 to 5 years for a third colonoscopy. My grandmother died of colon cancer so that might be an added risk. On the other hand, I have a very healthy diet and lifestyle and not sure how much to consider that.

I am also wondering if it would make sense to do the Cologuard test this year instead of the colonoscopy and stretch out the colonoscopy schedule. I worry about something going wrong with the colonoscopy, such as perforation. Not sure what the risks of perforation are versus the benefit of possibly detecting cancer with another colonscopy. Any thoughts or advice will be appreciated!

Dave

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  • Posted

    It's a no brainer!...as you had polyps removed in the previous 2 colonoscopies if you delay for a further year it could make all the difference as any new polyp can turn into tumours. I know it normally takes several years for polyp to turn into tumours but I wouldn't take the chance. I have Lynch Syndrome so have to have surveillance colonoscopies every 2 years, and normally have benign polyp removed. As for the risk of perforation it's always a concern. However when I first had a colonoscopy in 2004 i was told the risk was 1 in 500. But in 2018 the consultant said due to advanced techniques the risk had decreased to about 1 in 1,000's. As for the Cologuard test I don't have it because I feel it's unnessesary as I have a regular colonoscopy which is the gold standard test for bowel cancer, but its your choice if you want the stool test.. My main concern (besides the results) of a colonoscopy is the horrible prep!..I'm in uk by the way..regards.

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  • Posted

    Why would you take a chance like that? You have persistent polyps. I'm not a physician so I don't understand the clinical terms you cited. BUT...I had my first colonoscopy 8 years ago with symptoms. I was fortunate. It was a large pre-cancerous polyp at the end of my colon. I'd be dead now if I had not had that colonoscopy. The second was two years later, two benign polyps found (one is right ascending colon, rare). The third was two years after that, one benign polyp. I recently had a fourth and a benign polyp was found. I am 72. There would not be time for a pre-cancerous polyp to occur, and many do not become cancerous but even if it did, it takes approximately ten years for a pre-cancerous polyp to become cancer. In my case, no history of colon cancer that I know of, but trouble with colon for my Aunt, my mother, and my grandmother seems to have died of a bowel perforation (from her symptoms) a very long time ago before CT scans, etc. Have the colonoscopy. You're only 55. Perforation is rare. You can discuss this with your GI practitioner: what are his stats? Has he ever seen a perforation in his practice? etc. Cologuard was suggested for ME in TWO YEARS, rather than colonoscopy. If I were your age, I would not hesitate at all. This could save your life! Better safe than sorry! Just do it!

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  • Posted

    Thanks for both replies and it makes me more motivated to do the procedure earlier rather than later. I looked at one study this morning that showed that someone in my category - high risk from baseline colonoscopy and low risk on first surveillance had 6-13% chance of cancer on second surveillance. I think the risk of perforation is around 0.1% so if this information is correct, does look like a no brainer to go ahead with it soon. I am schedule next month and will discuss with my gi doctor again beforehand.

    My notes from 5 years ago said that my gi doctor has had a handful of perforations in 25 years and he said that most of those were when he was removing a polyp. He does quite a few per week so sounds very rare. I will ask about this again at the appointment.

    One reason I was questioning whether to do it now or wait to more years until 5 years is that I read that most polyps take a long time up to turn cancerous - maybe up to 10 years. But if there is a 6-13% chance of finding cancer in my category of risk, then it most grow faster in some or maybe there are polyps that are missed. Bottom line - sounds like risk of perforation is low and benefit of cancer detection is much higher. Any other thoughts or advice will be greatly appreciated!

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  • Posted

    Update - received results from Cologuard test and they came back negative. I have read Cologuard is close (92% cancer detection vs 97% colonoscopy) for cancer but only 40-50% on detecting polyps. Based on this and previous sessile serated polyp, mulitple other polyps, grandmother dying of colon cancer, still planning to go ahead with the colonscopy. Appointment with gi doctor tomorrow to ask any final questions. Any additional thoughts will be appreciated!

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