The Nebraska Colon
Cancer Screening Program

helps men and women 50 years of
age and older make decisions
about colon cancer screening.
Services may include:
For free or low cost screening,
click here.


View Answered Questions

I have fresh blood when I have a bowel movement. I have regular colonoscopys but I feel they don't show the outlet.

You are correct that colonoscopy is not a good exam for the outlet or anal canal. You most likely are suffereing from hemorrhoidal bleeding or other outlet bleeding. You should make an appointment with a physician such as a colon and rectal surgeon who is equipped to do a good anorectal exam and treat the findings appropriately.


How would you suggest encouraging reluctant family members to be screened?

Screening saves lives. Explain to them that screening is important not just for themselves but to those that depend upon them also. This includes co-workers, friends and families (children, grandchildren). Colorectal cancer is frequently preventable. Being able to prevent a cancer saves pain and suffering, not to mention huge costs. Even if you have health insurance, cancer care can lead to extensive personal out of pocket expense in both time and money.


How come I had to drink a 2 liter bottle of liquid for my prep and the guy sitting next to me in the waiting room got to take some pills?

There are many different bowel preps available for cleansing of the colon prior to colonoscopy however the 2 most common involve the use of a PEG solution (Go-lytely, Co-lyte, Nu-lytely, etc.) or Fleet Phosphosoda, the components of which are avilable in liquid or tablet form. No matter which prep you take, it will only be effective if you also drink large volumes of fluids. One major difference between the PEG solutions and other preps is that with PEG, the volume of fluid is included in the prep but with the others you can choose the fluids you want to drink, so long as they are "clear liquids". There are other medical reasons that you should have one prep over another depending upon your overall health. For example, people with underlying kidney disease or who might be susceptible to dehydration probably should not take phosphosoda solutions. Bottom line: you should discuss the prep with the physician doing your colonoscopy to see which prep is best for you.


My husband thinks he should be able to drive himself home after his colonoscopy, What do you think?

Only if he has it done without any sedation. A few patients do choose to do this but by far the large majority prefer some sedation so that they remain comfortable for the exam. If he has any sedation at all, he will not be able to drive himself home.


My father died of colon cancer 25 yrs ago. 5 yrs ago i had my first Colon check. Its time again. However, being self employed, and at this time not having insurance, is there any other way to get any kind of screening that i can pay for over time?

You can check with your physician as many times they will allow for payment plans if you do not have insurance. You can also apply to the Nebraska Colon Cancer Screening Program to see if you would be eligible for benefits. An application process is available at stayinthegamene.com.


I heard something on a medical program that indicated that polyps weren't the only colon concern, but also an inflamation of the lining which is possibly more dangerous. Is that inflamation hard to detect? Is it part of the colonoscopy exam? Thank you.

I don't know what type of inflammation you heard about on your program so I may not completely answer your question. However the most common type of inflammation we would associate with colon cancer would be inflammation associated with Inflammatory Bowel Disease or IBD. This is not to be confused with Irritable Bowel Syndrome or IBS. There are two types of IBD: Crohn's Disease and ulcerative colitis. Both of these are managed and confirmed by colonoscopy. A person with a history of IBD needs special screening at much more frequent intervals (every 1 to 2 years) and potentially begining at a much younger age than someone being screened simply because they turned 50 years old. The reason for such frequent exams is that changes associated with cancer in these situations can be hard to detect. Colonoscopy is the examination utilized to do that testing.


My mom was treated for colon cancer in 1997, she was 52 years old. I am 35 and I have rectal bleeding at times. Is is too soon for me to get a colonoscopy? What about my brother who is only 27, if he has no symptoms?

It is never too soon to have a colonoscopy if you have symptoms such as bleeding as you describe. This would be even more important to have done since your mother had colon cancer. In general, guidelines state that if there is a colon cancer or adenomatous polyp in a first degree relative (parent, sibling, offspring) before age 60, then screening should begin at age 40 or 10 years before the youngest case in the family. If you were asymptomatic, you should begin screening at age 40 (or 42 at the latest) but since you have bleeding, you should have a colonoscopy now. Your brother should have his first colonoscopy at age 40 unless he develops symptoms earlier.


My husband and I both had colonoscopies at about the same time. I was told to come back in 10 years and my husband was told to come back in 3 years. Why the difference in recommendations? We did go to different physicians for the procedures.

The recommendation for the timing of a follow-up colonoscopy after an initial examination depends on a number of factors, most importantly, the results of that initial examination. The most likely explanation for the discrepancy you have noted is that polyps must have been found in your husband's colon. A recommendation for a 10 year follow-up occurs when the screened individual has no risk factors for colon cancer other than age and the examination was normal. The finding of a polyp or polyps may mean a recommendation for a repeat colonoscopy at 5 years, 3 years or even one year or less depending upon the number of polyps, the size of those polyps, and the microscopic appearance or kind of polyps that were found. Other factors that may lead to the recommendation of a repeat colonoscopy sooner than 10 years include a family history of colon cancer or polyps and how well the colon was cleaned out for the examination. If the doctor doing the examination did not feel they got a good look at everything because the colon was not perfectly clean, they may want to repeat the colonoscopy earlier than would normally be planned. If none of these seem to explain your situation, you may want to ask your physicians why the difference or get a second opinion from someone who can review all of the details of your histories and the findings at the colonoscopies.


Colonoscopy are very costly and most insurance does not cover this. In today ecomomic times, people will be less likely to shell our the cash for the test. Question - could one expect to have Fecal Occult Blood test as part of a routine physical? And where is the least expensive plance to get a colonoscopy?

Colonoscopy is an expensive test but most insurance will cover it. Medicare will now cover screening colonoscopy. In Nebraska a law was passed a couple of years ago stating all health insurance sold in Nebraska must cover colon cancer screening according to American Cancer Society guidelines. So colonoscopy should be covered except in the case of ERISA policies which would be exempt. So if you do not have coverage, you might check to see if your policy is exempt. If not, you should find out why you're not covered. One should expect their doctor to discuss screening once they turn 50. However, many doctor visits are made because someone is sick and the preventive conversation may not come up until the original problem is solved. By then, many people don't return to the doctor so the prevention conversation may get lost and along with it, screening for colon cancer. This is so common because many people only think of going to the doctor when they are sick and once the get well, they don't go any more. We tend to be more reactive than proactive as patients. But to your question about fecal occult blood (FOBT), some discussion as to screening options should be a part of a routine exam once you reach age 50. Depending upon a patient's desires, this could be colonoscopy or FOBT or another approved test. If you doctor doesn't get to this during a routine exam, ask them about it. As to the least expensive place to get a colonoscopy, you should shop around just as you might for any other expenditure of that magnitude. If a center won't give you a price, then I would look for another center.


I had a colonoscopy 5 yrs ago, and only 1 smal polyp found, when do i need another screening? Will blue cross blue sh pay for this expensive process.

You will love the answer to this question but it "depends". First of all, it depends on what type of polyp you had. Adenomas are the type of polyps associated with colorectal cancer. Adenomas include serrated, tubular, tubulovillous and villous adenomas. Another common type of polyp is a hyperplastic polyp. Hyperplastic polyps are generally not associated with colorectal cancer, especially if they are single, isolated polyps. Secondly, it depends upon the size of the polyp. Thirdly, the shape of the polyp may make a difference, that is whether it was a flat polyp or on a stalk and fourthly, it depends upon the number of polyps you had. From what you said, you had only one polyp that was "small". Small polyps are usually flat so if that is correct then I am only missing one piece of information and that would be the type of polyp. If your polyp were hyperplastic, and you don't have a family history of colorectal cancer, then your next colonoscopy should be in 10 years. If you have a family history of colorectal cancer or if the polyp was an adenoma, then you most likely should have a colonoscopy in 5 years. The other variable I don't know is what the status of your colon was when it was examined, that is, how difficult the examination was or how clean your colon was. These variables could also make a difference on the recommended follow-up. So you see, your question is one that is best answered by the doctor who did your examination. As to the question about whether or not your insurance will pay for the follow-up examination, you would have to discuss that with your insurance company as your personal policy would determine that.


I have had precancerous polps in my colon the last two colonscopies, how often should I be checked? Also my father died of colon cancer.

Since your father died of colon cancer, you should be checked at a minimum of every 5 years. You may need to have more frequent examinations depending on a number of factors. Those factors include (1)the type of precancerous polyps, that is, were they serrated, tubular, tubulovillous or villous adenomas; (2) the number of polyps; (3) the shape of the polyps and (4)the size of the polyps. You should discuss this with the doctor who did the examination and have them explain to you why they have made their recommendation. You also may need to have more frequent examinations if your dad had colon cancer before he was 50 years of age or if you have more family members with colorectal and/or other cancers such as endometrial, ureteral, stomach, ovarian and pancreatic cancer. These cancers are sometimes associated with hereditary colorectal cancer. Finally, you may need to have more frequent examinations if you have family members with a history of colon polyps.


I have had the colon rectal home kit test, which was negative, I would like to know when a colonoscopy is needed.

If you are participating in a screening program that utilizes testing for stool blood (which most home tests do), then you need to have that test done every year. If you are going to switch to colonoscopy for your preferred screening test, then you should do so one year after your last stool blood test. Once you do colonoscopy for screening, you only need to do colonoscopy once every 10 years so long as your test remains negative. If you want to switch back to a home stool blood test after you have a colonoscopy, you can wait for 10 years to have your next stool blood test but you must then continue the stool blood test every year so long as that is the test you want to use.


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