As National Colorectal Cancer Awareness Month, March reminds us that while colorectal cancer is one of the most preventable cancers, it remains the third leading cause of cancer death. Colonoscopy is a way to detect colorectal cancer, but research has shown that not all colonoscopy technology is equally effective. Researchers at the Mayo Clinic campus in Florida report that high-definition colonoscopy is much more sensitive than standard colonoscopy in finding polyps that could result in cancer. This study was important because a large group of 2,430 people participated in the study, and it is the only study that has compared the two types of colonoscopy in a clinical practice setting. In colonoscopy, an endoscope is a lighted tube that is inserted into the colon and rectum to look for and remove polyps. A high-definition endoscope uses a high-definition video chip, and HD monitors (much like HD television). That increases the resolution of the image to make the procedure more effective. Researchers found that the rate of detection of polyps that are likely to become cancerous, or adenomas, was 29 percent among patients who were scanned with high-definition endoscopes. Yet, the rate of detection of adenomas was only 24 percent among patients who were scanned with standard endoscopes. While that increase may not sound like much, it would add up to significant numbers because 14 million colonoscopies are performed annually. All three Mayo Clinics (in Arizona, Florida, and Minnesota) only use high-definition endoscopes to perform colonoscopies now. Many other clinics have both kinds of endoscopes so they, too, can take advantage of the more effective technology. With these findings, it's now more important for those purchasing colonoscopy procedures to ask what technology the providers are using. Accuracy of Colonoscopy Depends on Specialist Performing Procedure It also appears important to be clear about what type of specialist will perform colonoscopy procedures. A study from the University of Toronto found that whether a colonoscopy is performed by a gastroenterologist, or another specialist, is equally important. Compared to statistics for a general population, the incidence of colorectal cancer is reduced for at least 10 years among people who have a colonoscopy that shows negative results. However, people with a negative colonoscopy do develop colorectal cancers. That makes it important that the specialist performing the colonoscopy has extensive formal training, especially when a colonoscopy is more challenging to perform. The University of Toronto study indicated that of the types of physicians who perform colonoscopy in hospitals, gastroenterologists are more proficient at colonoscopy than other physicians. That includes general surgeons. Considerable formal training in endoscopy is a part of gastroenterology training requirements in the U.S. and Canada, and that may be the reason for the increased proficiency among gastroenterologists. In the Toronto study, doctors identified 110,402 Ontario residents, ages 50 to 80, who had a negative complete colonoscopy between Jan. 1, 1992, and Dec. 31, 1997. The study continued to track participants through Dec. 31, 2006 to see if participants were diagnosed with colorectal cancer. During that 15-year period, 1,596 or 14.5 percent of the participants were later diagnosed with colorectal cancer. For those who had colonoscopies in a private clinic or office, endoscopist specialty was not significantly associated with later being diagnosed with colorectal cancer. Yet, among participants who had colonoscopies at a hospital (that was 86 percent of the study participants), those who had the procedure performed by a non-gastroenterologist (such as a family physician, general surgeon, or internist) were at significantly greater risk of later being diagnosed with colorectal cancer. With literally hundreds of Florida Health Insurance Plans available, it's important to select insurance that gives you access to the most effective levels of specialists and technology that can protect your health. When evaluating Health Insurance Plans in Florida, be sure to consider which hospitals are included as in-network providers. Most plans pay a higher percentage of your costs for in-network providers as compared to out-of-network providers.
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