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What You Should Know About Colonoscopies

By David Blyweiss, M.D., Advanced Natural Wellness

A New England Journal of Medicine article recently received a lot of press, with headlines suggesting that perhaps colonoscopies aren’t that useful after all.

But that’s misleading, because most of the news reports failed to focus on the most significant part of the article. As journalists like to say, “they buried the lead.”

You see, a research team invited 40,063 people between 55 and 64 years of age to have a colonoscopy. Another 56,365 people were not invited.

After an average of 10 years, colorectal cancer cases were reduced by 18% in the group that was invited to have colonoscopies when compared to the group who were not.

That doesn’t sound like much of a reduction… until you learn that nearly 60% of the people invited to have a colonoscopy didn’t get one!

It’s easy to see how that could put a big hitch in the study results. But if you remove the “no-shows” from the equation, the numbers are pretty impressive. Those who actually underwent the colonoscopy had a 31% decrease in colorectal cancer and a 50% decrease in cancer-related deaths.

So I think the real message here is that the only way a colonoscopy can prevent colon cancer is if you actually get one!

Colonoscopy: Visualize, Examine, Remove and Biopsy

Colon cancer is the third most common cancer in the U.S. But it’s one of the most preventable and treatable forms when it’s detected early enough. However, if it’s not caught in the early stages, it can be one of the most deadly.

This is why I recommended that anyone with an average risk of the disease should begin regular screening by the age of 45 – or even earlier if your normal bowel habits become abnormal for you. 

As far as detection rates are concerned, I still believe colonoscopy is the gold standard. It literally allows the doctor to see the inside of your intestines with a tiny little camera. And if he sees a potentially pre-cancerous polyp, he can remove it immediately.

It’s something most people only need to do once every ten years, and it’s the only way to directly visualize, examine, remove and biopsy all in a single screening.

It’s considered a routine test for gastroenterologists who can perform them in outpatient settings.

However, a colonoscopy is only as good as the person doing it. So you’re much better off with a doctor who specializes in the procedure and has access to hospital equipment in case of a complication.

In other words, choose a trusted doctor who performs a lot of colonoscopies.

Other Cancer Screening Alternatives

The only good colorectal cancer screening is the one that you are willing to participate in. And any type of screening is better than none at all. So if you’re dead set against having a colonoscopy, fecal and DNA tests are acceptable alternatives.

Two common stool tests are the fecal immunochemical test (FIT) and the fecal occult blood test (FOBT). Each of these tests is able to find small amounts of blood in the stool that you can’t see with the naked eye. If blood is detected, it could be an early sign of cancer.

However, neither FOBT or FIT are able to reliably detect cancer precursors like polyps and adenomas.

And I’m sure you’ve seen the TV commercials for Cologuard®. It’s a specific type of test that looks for tiny amounts of blood while also looking for certain DNA biomarkers and genes found in colon cancer.

Cologuard® is pretty good at detecting early and late-stage cancers, but again, it’s not going to tell you if you have polyps that might turn cancerous.

One thing you should be aware of is that there is a decent percentage of both false positives and false negatives with these tests.

Any positive result, whether false or not, will require a follow-up colonoscopy. And any negative result can potentially be a false negative, which can lure you into a false sense of security.

So all of these tests have their pros and cons. The bottom line is that if anything potentially cancerous is growing inside your colon, it needs to come out.


Bretthauer M, Løberg M, Wieszczy P, Kalager M, Emilsson L, Garborg K, Rupinski M, Dekker E, Spaander M, Bugajski M, Holme Ø, Zauber AG, Pilonis ND, Mroz A, Kuipers EJ, Shi J, Hernán MA, Adami HO, Regula J, Hoff G, Kaminski MF; NordICC Study Group. Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death. N Engl J Med. 2022 Oct 27;387(17):1547-1556.

American Cancer Society Responds to NEJM Colonoscopy Study. American Cancer Society. Oct 2022.

Mankaney G, Sutton RA, Burke CA. Colorectal cancer screening: Choosing the right test. Cleve Clin J Med. 2019 Jun;86(6):385-392. Ahlquist DA. Stool-Based Tests Vs Screening Colonoscopy for the Detection of Colorectal Cancer. Gastroenterol Hepatol (NY). 2019 Aug;15(8):437-440.