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Published on April 11, 2019

illustration of a colon in the body

5 Common Questions About Colon Screening

You have questions, so we got you answers. Here’s what the experts have to say.

Why do I need to get screened?

Colon cancer is pretty common and one in three people who get the disease will die from it.

Here’s how colonoscopy is different: most screenings detect existing cancer earlier. “Of all the screenings out there, colonoscopy is the most effective way to prevent cancer before it even develops,” said Christopher Hurley, MD, gastroenterologist with Avera Medical Group.

But I feel fine, so can’t I just skip it?

The colonoscopy is actually for healthy people, said Eldon Becker, MD, FACS, general surgeon with Avera Medical Group. “The screening allows a person to know that they don’t have something inside their colon that can become substantial.”

One in 22 men and one in 24 women will be diagnosed with colorectal cancer in their lifetime. One of the reasons colon cancer is the No. 2 in cancer-related deaths is because there are no symptoms until it is at a later stage. If you are nearing age 45, or you're older, you should talk to your doctor about scheduling one.

“You can have a very significant advanced cancer in your colon and have absolutely no symptoms,” Hurley said. “It’s very common for a patient to say, ‘I feel fine, I don’t need the test.’ That’s like saying I don’t have skin cancer because my skin doesn’t itch.”

Is colonoscopy my only screening option?

No, but it’s considered the most effective option. Here’s why:

  • It offers doctors a visual view of the colon to see polyps that may be harder to detect.
  • Other tests, such as sigmoidoscopy or stool samples, can detect cancer but they’re not good at detecting pre-cancer.
  • If a polyp is seen it can be removed on the spot.
  • If you do another type of screening and there is a concerning finding you’ll still have to do a colonoscopy to identify the concern.

That said, any screening is better than no screening, Becker warned. “We highly discourage watchful waiting and doing nothing at all. Waiting is not a screening option and is a dangerous approach.”

Is there a way around the prep?

Well, no. There are different ways to do the prep, such as drinking the fluid in a split dose. Talk to your provider about the best option before your procedure.

There’s a reason people must drink fluid before the procedure. Hurley likens the prep to a “power wash” of the colon lining so doctors can get the clearest view of all different shaped polyps, including ones that are flat and harder to see.

Will it hurt?

While you can have a colonoscopy awake that’s not common. In most cases you’ll be sedated for the procedure so you won’t feel a thing. Very little of the procedure will be remembered at all. Learn more at

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