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Overview
Colon cancer screening over the years has become more aggressive in the United States because unfortunately the incidence of colon cancer is rising. We believe it may be due to dietary and environmental effects. The medical community now recommends initiating colon cancer screening in average-risk patients at the age of 45.
Options for screening including colonoscopy (the gold-standard, as it can remove polyps at the time of procedure), and Cologuard (a non-invasive stool test). Dr. Cober provides both of these options and can tailor your screening based on your situation.
Related to colonoscopies, we also offer upper endoscopies (EGDs).
With respect to Cologuard, this can be prescribed by a patient's primary care provider.
We exceed national benchmarks for quality standards regarding adenoma detection rate:
Overall ADR: 68% (benchmark >35%)
Screening ADR, females: 44% (benchmark >20%)
Screening ADR, males: 50% (benchmark >30%)
Successfully reach cecum: 99.4% (benchmark >90-95%)
Are colonoscopies safe?
Colonoscopies are exceedingly safe. The complications to watch for, bleeding and perforation, occur in less than 0.3% of patients. Our safety record is lower and we aim for no serious complications. As colonoscopies are often a screening procedure and rarely acutely therapeutic in the outpatient setting, we have a low (zero) tolerance for complications.
For patients who undergo colonoscopy, their risk of developing colon cancer is 30% lower (due to polyp removal), and they have a 50% in reduction from mortality from colon cancer
How Difficult is The Laxative Preparation?
Following encouraging studies we have adopted a simpler approach to colonoscopy preparation. Whereas in past times, patients often had to do a 1-2 day liquid fast prior to colonoscopy in addition to utilizing a gallon of laxatives. For some patients with severe constipation this is still utilized.
But for the vast majority of patients we follow a more modern simplified prep:
Breakfast and lunch the day before are allowed with low-fiber foods.
Starting after lunch, clear liquids and the laxative prep which includes simpler options with less to drink.
We typically do not ask patients to wake-up in the middle of the night to finish the laxatives.
Can an upper endoscopy be done at the same time as a colonoscopy?
Yes, in fact, for patients with reflux or a history of Barrett's, many times an upper endoscopy (EGD) is performed at the same time as a colonoscopy, or it can be scheduled as a stand-alone procedure.
Are there alternatives to colonoscopy?
Yes, there are stool tests that can be done such as Cologuard. This is a fairly sensitive test. It is most often recommended for patients who have never had a polyp or for patients with significant cardiopulmonary conditions seeking to avoid anesthesia. Note one of the downsides is that any polyps not detected will not be removed.
If polyps are found are they removed?
Yes the vast majority of polyps are removed in their entirety. This is one of the major benefits of colonoscopy over stool tests. By removing polyps, we are preventing cancers from developing.
Certain large polyps or cancers may be tattooed so that they can be removed at a later time by surgery or using advanced endoscopic techniques.
How safe is anesthesia?
Anesthesia is extremely safe and actively monitored by dedicated anesthesia providers continuously. A light "twilight" sedation is utilized. We also utilize the water-immersion technique and carbon dioxide insufflation to minimize pain and medication requirements.
Can hemorrhoids be treated at the same time as a colonoscopy?
Yes they can -- procedures such as banding, HemWell, and even surgery can be coordinated to occur at the same time as a colonoscopy.
Schedule a Colonoscopy or a Consultation
For many patients who are eligible for a screening colonoscopy or where a primary care provider orders a colonoscopy and/or an EGD, there is no consultation required with us prior to the procedure. For other patients with more complex situations we do recommend starting with a consultation.
Insurance and Payment Information
We are in-network with Medicare and accept a wide variety of insurance plans. If we are not in network with your plan our billers can often negotiate with payors such that patients pay the same as they would with an in-network provider. In the event that our biller is unable to obtain in-network rates for you, we will inform you and quote any out-of-pocket costs upfront.
For Referrals From Providers Offices
Step 1: Fax/email us the last clinic note or any other relevant information such as history and recent colonoscopy.
Fax: (561) 693-2210
Email: secure@coberhealth.com
Step 2: We will reach out to the patient and schedule them for directly for the procedure or a consultation.
Step 3: We will update you with our findings and recommendations.
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