Tampa doctors show concern for colon screening
by Jackie Norris
As a survivor of intestinal lymphoma, James Barca, 67, jokes that his doctor is as familiar with his face as he is with his colon. "I have no clue how many colon exams I've had over the years," the Pinellas Park [Fla.] resident says. "But my doctor is on a first-name basis with my rectum and intestines."
Before a doctor diagnosed his condition in 1995 and removed portions of his colon and large intestine, the Angie's List member had a sigmoidoscopy to screen for colorectal cancer. "All I recall is that nothing was found, but that probably kicked off my routine colonoscopy exams," he says.
For those age 50 and older, the Centers for Disease Control and Prevention recommends regular colorectal cancer screenings: a colonoscopy every 10 years, or a sigmoidoscopy every five years in conjunction with fecal occult blood testing annually. A colonoscopy is the only method that examines the entire colon and removes polyps at the same time.
Dr. Robert Theobald, a highly rated gastroenterologist in Tampa [Fla.], says some patients opt for a sigmoidoscopy in lieu of a colonoscopy since the procedure typically costs less and doesn't require sedation or anesthesia. "They used to be done a lot more," he says. "Some people still do it, but it's an incomplete test."
Sigmoidoscopies only examine the left side of the colon. The FOBT detects blood found in the stool, which may indicate bleeding tumors or precancerous polyps.
Dr. Harry Papaconstantinou, communications chair for the American Society of Colon and Rectal Surgeons, says although approximately 60 percent of cancers are found on the left side of the colon, nearly 40 percent are found on the right side.
"If you're concerned about being screened for colon cancer, you don't want to exclude the right side of the colon," he says.
Dr. Isaac Kalvaria, a gastroenterologist with highly rated Sarasota Digestive Health Specialists, says the limited amount of colon that's viewed during a sigmoidoscopy makes them insufficient tests. "Performing a sigmoidoscopy to screen for colon cancer is equivalent to performing a mammogram on one breast," Kalvaria says. "There's no doubt that a colonoscopy is the most sensitive and specific screening procedure."
Kalvaria says screenings that don't examine the entire colon might give patients a false sense of security. "I've diagnosed patients with right-sided colon cancer who were surprised," he says. "They were sure they had been screened within the appropriate time, but they had an inadequate procedure, such as a sigmoidoscopy, done."
Theobald also warns consumers that a colonoscopy will be needed if an alternative method identifies abnormalities. "If your doctor finds a polyp in the sigmoid, then they will need to perform a colonoscopy - otherwise it's just poor medicine," he says.
Barca advocates for colonoscopies. "I think sigmoidoscopies are a waste of time and money," he says. "My cancer activity was farther up in the large intestine and wouldn't have been detected."
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.