There are many choices for early detection

Learn about the colonoscopy process on this page. Then, don't miss our curated list of 27 Insider Tips & Tricks For Prep.

Who should get a colonoscopy 

• Colonoscopy is the gold standard in colorectal cancer screening 
• Anyone who is at higher risk of colon cancer or rectal cancer should be screened using this method
• Colonoscopy is also a good option for people at average risk of colon cancer or rectal cancer

Advantages

• Most complete screening method available
• Allows doctor to identify and remove polyps (growths that can turn into cancer) in the same procedure
• Sedation is usually given to patient to minimize discomfort
• Examines full colon
• Depending on results, may only need to be re-screened every 10 years

Disadvantages

• Requires one day of clear liquids and laxative preparation
• Will need to set aside a day for the procedure and have a ride home to leave the medical facility
• Small risk of perforation or bleeding

What can I expect for a bill?

The average cost of a colonoscopy before insurance is $800 – $1,600.

Will my insurance cover it?

Under the Patient Prevention and Affordable Care Act (PPACA), all insurers are required to cover preventive screening tests, including colonoscopies. 

If symptoms of colorectal cancer are present, your screening may be considered “diagnostic” rather than “preventive,” and your insurance may require a copay or deductible. This will vary based on where you live and your insurer’s policies. Talk to your provider and your insurance company to learn more.

The facts

You’ll often hear colonoscopies referred to as the “gold standard” for screening. This is because doctors can both find cancer and remove potentially precancerous growths called polyps in the same procedure. Because most cases of colorectal cancer start as polyps, colonoscopies help stop colorectal cancer before it even starts!

The prep

We’re not going to lie – colonoscopy prep is generally considered the most difficult part of the procedure. The good news? Once you’re done with the prep, the rest is easy! 

To get ready for a colonoscopy, full bowel prep is required. Your doctor will give you specific directions on how to prepare. Generally, all solids must be emptied from the stomach and bowel by following a clear liquid diet for 1-3 days before the procedure. You should not drink beverages containing red or purple dye. A few examples of what you can drink include:

• Fat-free bouillon or broth
• Strained fruit juice
• Water
• Plain coffee or tea
• Sports drinks, such as Gatorade
• Gelatin

A laxative may also be required the night before a colonoscopy to loosen stool and get your bowels moving. Immediately after the procedure, you won’t be permitted to drive, so be sure to arrange a ride home beforehand.

The procedure

During a colonoscopy, you will lie on your left side on an examination table. In most cases, your doctor will give you a light sedative, and possibly pain medication, to help you stay relaxed. The doctor will then insert a long, flexible, lighted tube with a camera called a colonoscope, or scope, into the anus and slowly guide it through the rectum and into the colon. The scope inflates the large intestine with carbon dioxide gas to give the doctor a better view. The small camera mounted on the scope transmits a video image from inside the large intestine to a computer screen, allowing the doctor to carefully examine the intestinal lining. The doctor will examine the entire colon searching for anything abnormal and remove polyps, which are growths in the lining of the colon that can turn into cancer. Once the scope has reached the opening to the small intestine, it is slowly withdrawn and the lining of the large intestine is carefully examined again.

Removal of polyps and biopsy

A doctor can remove growths, called polyps, during colonoscopy and then send them to a lab to test for signs of cancer. Polyps are common in adults and most are usually harmless. However, most cases of colon cancer begin as polyps, so removing them early is an effective way to prevent cancer.

The doctor can also take samples from abnormal-looking tissues during colonoscopy for later review in a lab. A lab scientist will look at the tissue with a microscope for signs of disease.

Does it hurt?

A colonoscopy can take anywhere from 15 to 60 minutes, usually averaging 20 to 30 minutes, depending on what is discovered. When performed by an experienced health care practitioner, the procedure is painless. To relieve anxiety or pain, some form of anesthesia or sedation is provided. A sedative together with pain medication enables people to better tolerate the procedure, and the drugs induce relaxation and drowsiness.

The big 'what if…'

Any biopsies taken from your colon during the colonoscopy will be sent to a lab for testing. You should hear results within a week of your procedure. If anything abnormal is found, your gastroenterologist and primary care doctor should discuss a follow-up plan with you.

I've been diagnosed with colorectal cancer. What now?

We’re here for you, and we are on your team. If you or a loved one has been diagnosed with colorectal cancer, we encourage you to get in touch with us:

• Call our toll-free Helpline at (877) 422-2030
• Visit our online community 
• Check out the Alliance’s other support resources 

Everyone deals with a cancer diagnosis differently. Our Patient & Family Support team is trained to provide you and your caregivers with information and support during this confusing and overwhelming time.

After the test

Patients may experience cramping or bloating after the procedure. If you receive a sedative, it will take 1-2 hours to lose its effect. Patients may need to remain at the clinic until this happens. The upside: A full recovery is expected by the next day. Side effects of colonoscopies are rare, but patients should contact their doctor if they experience:

• Severe abdominal pain
• Fever
• Bloody bowel movements
• Dizziness

Rarely, a patient may experience tearing or perforation of the lining of the intestine. If this happens, surgery may be needed to repair the injury. Another risk is bleeding, usually at the site of a biopsy or polyp removal. Most cases of bleeding stop without treatment or can be controlled at the time of procedure.

How often (if not high risk)

As with many things, it depends. For people at average risk who have no polyps found, a colonoscopy should be performed at least every 10 years. If polyps are found, or if you are at high risk for colorectal cancer, your doctor will make specific recommendations for follow-up exams depending on the type of polyp detected.