Lynch syndrome (also known as hereditary nonpolyposis colon cancer) greatly increases the risk for colon and rectal cancer. People with the gene have about an 8 in 10 chance of getting colon cancer during their lives. Because Lynch cancers develop quickly and grow rapidly, it’s important to monitor people who carry the genes closely with colonoscopy every year or two.

When doctors in four research centers immediately followed up Lynch syndrome patients after a regular colonoscopy with more intense colonoscopy scrutiny, they discovered they had missed more polyps than they found.  During the first exam, their miss rate for adenomas, polyps with the greatest risk of developing into cancer, was 55 percent. Read the rest of this entry »

Even if a patient had a previous clear colonoscopy or all polyps seen on that exam were removed, a new positive fecal occult blood test (FOBT) calls for a repeat colonoscopy.

After 21,600 clear colonoscopies done at the Veterans Administration Medical Center in Phoenix, 57 patients needed a second colonoscopy after they had a positive FOBT for blood in their stool. Of those one-third (19) had a newly discovered adenomatous polyp and 3 had colon or rectal cancer.  One in four of the new adenomas were advanced. Read the rest of this entry »

Polyps on right found with retroscope

Doctors using a new optical device mounted on the end of their scopes, found significantly more polyps in the colon during routine colonoscopies.  Called the Third Eye Retroscope™, it lets gastroenterologists see both forward and backward as the scope moves through the colon.

Although colonoscopy is extremely sensitive and will discover most colon polyps during an exam, some are missed.  They may be hidden in the back side of folds in the colon wall or not seen because they are outside of the half circle view of the standard colonoscope.   The wider view allowed doctors to find 13 percent more polyps and 10 percent more adenomatous polyps, the ones more likely to become cancer. Read the rest of this entry »

When patients were retested five years after a negative colonoscopy, none had colon or rectal cancer and very few had a worrisome advanced polyp. Read the rest of this entry »

News from Digestive Disease Week 2008

A tiny microscope, less than one-sixteenth of an inch, attached to the end of the instrument used for a colonoscopy can provide magnified pictures of cells and small blood vessels in suspicious lesions allowing doctors to make on-the-spot decisions about whether a polyp is benign or precancerous.

The technique — confocal endomicroscopy — can identify benign polyps 98 percent of the time, avoiding having to remove the lesion and wait for results of the biopsy.  Precancerous polyps can be viewed, identified, and treated immediately during the colonoscopy. Read the rest of this entry »