The right specialist matters. Colonoscopies are performed by different types of providers, depending on the region’s resources. Primary care providers, surgeons, and other endoscopists are known to do colon cancer screening. A recent study out of Canada reflects that gastroenterologists have a better adenoma detection rate than these other specialists. This is particularly significant for patients in regions not as thoroughly served by medical providers as, say, places like Seattle or San Francisco.

Colon cancer is well known as one of the few cancers that can be prevented by adequate screening. The recommendation these days is that colon cancer screening begin at 45 years of age. Home cancer screening kits are now available for patients to do a preliminary screening from their own home. If the test is returned abnormal, it means that blood is appearing in their stool. Blood is often an indicator of polyps or early cancer, and an abnormal screening result should lead immediately to a colonoscopy. A colonoscopy performed by a properly trained specialist should then identify the abnormality. The study out of Calgary confirmed that gastroenterologists are more likely to identify an abnormality than are surgeons or other endoscopists.  

Folks in remote rural areas are less likely to have access to a gastroenterologist, so may be forced to rely on other specialists to perform the screening for them. Unfortunately, this study demonstrates that these folks are more likely to be falsely assured by a negative colonoscopy. The troubling thing about that – aside from the cancer diagnosis itself – is that when discovered, it is more likely to be a more advanced, and dangerous cancer.