Do you need a colonoscopy?

Dr. Niraj Gupta

Dr. Niraj Gupta

Angie's List member Mary Kraeszig of Zionsville, Ind., says the colonoscopy she received to screen for colorectal cancer went well, but the required bowel preparation caused severe cramping. "It was most painful," she says.

Some patients forgo the procedure altogether because of the preparation, says Dr. Douglas Rex, a highly rated Indianapolis gastroenterologist and director of endoscopy at IU Health University Hospital. "Even for someone who's had a colonoscopy performed, they might not want to go through the prep again," he says.

Although some patients find the prep uncomfortable, Indianapolis oncologist Dr. Niraj Gupta says a colonoscopy provides the most thorough evaluation available. But alternative options, such as sigmoidoscopy and fecal occult blood tests, also exist for patients with no family history or other risk factors. "Any screening method is better than nothing at all," Gupta says.

The Centers for Disease Control and Prevention reports that as many as 60 percent of colorectal deaths could be prevented if everyone age 50 and older received screenings.

Each screening alternative carries an important caution to health consumers: "If any of the tests are positive, the colon would have to be evaluated through a colonoscopy," says Dr. Harry Papaconstantinou, communications chair for the American Society of Colon and Rectal Surgeons.

Colonoscopies provide another advantage: Doctors who perform them also remove polyps or do biopsies during the procedure.

For patients like Kraeszig, who prefer not to be sedated because of allergies, a sigmoidoscopy provides an alternative. The test involves inserting a scoped instrument through the rectum to examine only the lower third, or left side, of the colon. Although it requires similar bowel preparation as a colonoscopy, it typically takes less time, costs less and doesn't require sedation.

However, since a sigmoidoscopy only examines a portion of the colon, Papaconstantinou says it fails to detect abnormalities in other areas visible during a colonoscopy. "If you're concerned about being screened for colon cancer, you wouldn't want to exclude the right side of the colon," he says.

The CDC recommends a colonoscopy every 10 years, or a sigmoidoscopy every five years after age 50 in conjunction with fecal occult blood testing annually. FOBT detects blood found in the stool, which may indicate bleeding tumors or precancerous polyps. The test costs far less than more invasive procedures, but it doesn't detect nonbleeding but potentially precancerous polyps. Gupta says it's still more effective than forgoing screening all together. "Studies have shown that it reduces the mortality rate from colon cancer," he says.

Kraeszig says the colonoscopy she received detected polyps. "I'm satisfied I did the right thing in having a colonoscopy," she says. "In the end, I would have still faced a colonoscopy to remove the polyps.

By the numbers

Healthcare Blue Book publishes “fair rates” (the average fee that providers accept as payment from insurance companies) for the following colorectal cancer screenings in the Indianapolis area:

-Colonoscopy $1,070 without biopsy; $1,411 with biopsy

-Sigmoidoscopy $235 (no anesthesia); $637 (anesthesia, if required)

-Fecal occult blood tests $23 to $45 (plus possible offi ce visit fees)

Sign in to Angie's List to check out more medical pricing from Healthcare Blue Book.


Mr. Sharath, I'm fairly sure the health insurance industry is much different in India than it is here in the United States. That and I'm fairly confident that the safeguards, and standards of care are much higher here than in some of your hospitals. That said, I do think the cost of healthcare is outrageous in the US. Even if I had to pay $1500 for a colonoscopy, I'd still find it well worth it given the potential consequences of not having it done!

I am sure there are other countries who have safeguards and standards of care better or higher than the U.S.. You are wrong in that the cost of healthcare is outrageous in the U.S.! Believe it or not our doctors do not walk on water. They are in the business for the money and no one is controlling the cost of care here. You get all the colonoscopies you want. I'll pass (due to costs among other things).

Wow ! A thousand dollars for the colonoscopy test ! USA is not a place where people can afford to fall sick.The same tests cost a hundred fifty dollars in Bangalore in a good hospital. Mind boggling expense.

I had a colonoscopy recently and took several strong pills instead of drinking the gallon of fluid they gave me. The pills cleaned me well enough that the doctor thought I drank that nasty drink. The pills were ducolax I took four.

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