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My husband's pulps in right colon - Colonoscopy Reduces Death from Cancer in the Left Colon, but Not the Right.

By February 28, 2010 - 7:53am
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My husband (51 years old) who has a family history of colon cancer had two colonoscopies on annually over the last two years. Each time the doctor found pulps in his right colon. I read that Colonoscopy Reduces Death from Cancer in the Left Colon, but Not the Right. What would you suggest my husband does in order to minimise the chances of getting cancer? Screening more frequently then every 12 months? Are there any special machines or doctors that specialise in right colon? We have access to the very best doctors and have great private insurance, so we have no limits in terms of access. We just need to educate ourselves in terms of what is best for my husband. Also he is terrified of doctors so it means that I am doing all the work as he is in denial.

Please see article below:

In a large case-control study performed by researchers at the University of Toronto, patients who had undergone colonoscopy at least once were significantly less likely to die of colorectal cancer (CRC) arising in the left side of the colon (the part of the colon closest to the rectum) than patients who had never had a colonoscopy. However, colonoscopy did not reduce mortality from CRC in the right side of the colon, according to results published in the December 15, 2008, Annals of Internal Medicine (see the journal abstract).

Using four Ontario-based databases, the investigators matched 10,292 patients who had died of CRC with 51,460 controls who did not have CRC. Each patient was matched to five controls by age, sex, income, and location of residence, and all controls were alive at the date of the patient’s death.

Because the investigators could not distinguish screening colonoscopies from diagnostic colonoscopies using the database records, they excluded all colonoscopies done within six months before a diagnosis of CRC.

Seven percent of case patients and almost 10 percent of controls had undergone colonoscopy. “Case patients were less likely than controls to have undergone any attempted colonoscopy…or complete colonoscopy,” stated the authors. Both attempted and complete colonoscopy reduced the likelihood of death from left-sided CRC, but not right-sided CRC.

The reasons for the lack of efficacy in preventing right-sided CRC are not clear, but may include less effective bowel preparation or colonoscopy technique in the right colon or differences in the biology and natural history of cancer arising in the right colon, explained the authors.

These results “seem consistent with a CRC mortality risk reduction of about 60 percent to 70 percent for the left colon and highlight the fact that we have very little data…about efficacy in the right colon,” said Dr. David Ransohoff of the University of North Carolina at Chapel Hill, in an accompanying editorial.

Add a Comment7 Comments

Hi Samurai,

I am sending you a Private Message (PM) with some contact information for you.

For others interested in this thread, I am recommending to Samurai to contact the author's of the research article for specific information (this article requires a subscription to view full text, and it not available for patients...unless you have access to a university medical library or other means).

Here is the PubMed version of the article referenced above:

March 11, 2010 - 3:23pm
HERWriter Guide (reply to Alison Beaver)

Great links, Alison - thank you!

Samurai, these should answer some of your questions.

Again, colonoscopies more than every 12 months are not generally recommended, even for those with a history of colon cancer - although each case is decided on it's own merits. Your husband's gastroenterologist can answer this for him.

March 12, 2010 - 1:34pm

I still have not heard from anyone about my question. When can i expect to have an answer please' Thank you.

March 6, 2010 - 5:38am
HERWriter Guide (reply to Samurai)

Dear Samurai

Our focus on Empowher is to guide our readers and members to find their solutions to their health problems, by working with their own team of health care providers and by doing their own research, based on guidance by HerWriters and Guides. We also welcome comments from other readers who may have experience in the same health condition so that everyone can benefit from the experience of others.

We cannot and do not offer specific medical advice for individuals in terms of diagnosis, treatment or recommendations with regard to diagnostic tools pertaining to a specific patient. We work with many readers so "comprehensive" answers are not always possible. I love that our team has helped you out so much with other questions (that's always our goal!) but please do not rely on Empowher writers to conduct in depth research for one member - we simply do not have the capacity for that because our aim is to guide and empower our members into being their own health care advocate. This takes a lot of time on our part and we really enjoy guiding people in the right direction! This has always been the goal of Empowher.

Questions submitted to experts can take some time. Many are medical professionals (doctors, nurses, Ph.Ds and naturopaths and homeopathic experts). They reply as quickly as they can but we receive many, many requests so unfortunately there can be delays.

I am familiar with the study you have linked us to (thank you for doing that as it helps us pinpoint your concerns) and as of right now, there are no specific methods (or machinery) that can target the right side more specifically. But I have some information that may help you:

-The reasons why right sided colon cancer is harder to find are varied. One reason is that the cancer grows differently in the right side that the left. Polyps grow faster on the right side and lay flatter so they are more difficult to detect. Using the prep solutions the night before 100% as instructed can help doctors view the right side more efficiently. Many patients do not complete the prep exactly as instructed.

- Other experts have recommended that a qualified gastroenterologist is the best bet for performing the procedure and reviewing results. You may want to specify that you'd like a gastroenterologist to do the colonoscopies.

-Colonoscopies are not recommend more than every 12 months. The rate of complications for this kind of cancer screening is significantly higher than for other kinds.

I do thank you for your patience as we try to research ways to guide you along your way. I know it's a very worrisome time for you and your husband.

I wish you and your husband the best.


March 6, 2010 - 6:55am
(reply to Susan Cody)

Thank you Susan. We have the same doctor do colonoscopy each year. He is Adjunct Assistant Professor of Gastroenterology. Could you find out if having a colonoscopy every 12 months would reduce the chances of getting cancer? Did the subjects in the study I quoted have colonoscopies every 12 months and therefore was the % rate of catching right colon cancer based on that?

March 11, 2010 - 4:17am

Hi Samurai,

I wanted to let you know that we received your question, and are reviewing the material and resources you sent, and we will respond soon!

Alison Beaver
EmpowHER Guide

February 28, 2010 - 2:50pm
(reply to Alison Beaver)

Thank you Alison. Please try to give me a very comprehensive answer and take your time to do the research as this is EXTREMELY important issue for us. Usually I get very educated answers here but recently I got some "quick" answers, i.e. "ask your GP doctor for guidance" which I of no use to me as I have already asked my doctors.

March 1, 2010 - 4:38am
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