Is it time for my colonoscopy ? A History Lesson

I believe this is the question that gave rise to the new breed of flourishing gastroenterologists (GIs). A lot of people do not know that in 70s and 80s hardly any one wanted to become a gastroenterologist in US. Obviously, endoscopy was in its infancy stages, and not well established. Hence, the GI physicians of that era would treat diseases with medications, and limited endoscopic intervention. This lead to low revenue and even a lower likability quotient among graduating medical residents .

It was in early 1990s that Medicare established guidelines for colorectal screening. Along came the “gold pot” and a new breed of floursihing  GIs. Over the next decade guidelines for screening and surveillance were tested and  established.  However, the practicing GIs continued to ignore the guidelines and performed procedures at their will out of ignorance or greed.  This practice has continued till date among the GI community.  It was sad to see two patients in my clinic today who had been getting  yearly colonoscopies by their GI for small hyperplastic polyps, for which guidelines of no further colonoscopy till 10 years had been established at least 20 years ago.

So in short, the answer to the question – is it time for my colonoscopy rests solely on the honesty of your treating GI physician.

A glance at the some of the current guidelines for colonoscopy intervals :

  1. Average risk individual (no family h/o colon cancer) : every 10 years if no polyps noted.
  2. High Risk individual (family h/o colon cancer) : every 5 years
  3. Individual with polyps, less than 3 adenomas : every 5 years
  4. Individual with > 3 adenoma polyps : every 3 years
  5. Individual with complex polyp (flat, piecemeal resection, large) : months to year depending on the case

I hope the patients themselves gain enough knowledge to learn about the timing of their future colonoscopy, and prevent unnecessary interventions.

If you have any questions, please drop an email : coastal@gmail.com or call my office 281-557-2527.

Dr. Adi Malhotra

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