What to Say to Someone Who is Reluctant to Have a Colonoscopy Screening

By Dr. Scott Estabrook, Medical Director, Gastroenterology, Nuvance Health

If you had a chance to prevent cancer, would you take it? That might seem like an obvious answer, yet some people do not want to have a colonoscopy screening, which can prevent colorectal cancer.

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As a gastrointestinal doctor who has performed thousands of colonoscopies, I know this important screening is painless, prep options have improved, and the endoscopy care team maintains each patient’s dignity during the procedure.

Here are common reasons why some people do not want to have a colonoscopy screening, and what to say to them to help alleviate their concerns.

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I do not need a colonoscopy screening because I am not at risk for colorectal cancer.

Colorectal cancer, which includes colon cancer and rectal cancer, is the third most common cancer diagnosed in people in the United States. While colorectal cancer is most common in people older than 50, it can occur to anyone at any age. In fact, the rate of colorectal cancer among people younger than 50 has increased over the last 30 years.

While we need more research, experts think that lifestyle habits such as eating an unhealthy diet, not exercising, smoking cigarettes, and drinking alcohol in excess might contribute to colorectal cancer developing in younger people.

If you have a family history of precancerous polyps or colorectal cancer, you may also be at increased risk for the disease.

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Regular colonoscopy screenings can prevent colorectal cancer, or also detect it early when it is more treatable. The United States Preventive Services Task Force (USPSTF) recommends people at average risk of colorectal cancer start screenings at age 45.

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Why do I need a colonoscopy screening if I do not have symptoms?

Screenings are for people who do not have any symptoms. During a colonoscopy screening, your gastroenterologist can remove precancerous polyps — and prevent cancer from developing. They can also find small cancers before they cause symptoms. Early detection is key to having a positive outcome when it comes to cancer.

I feel embarrassed to have a colonoscopy screening.

It is valid why some people feel embarrassed about having a colonoscopy because it involves a part of the body they want to keep private. Further, everyone needs to tell at least one person about it because they need a ride home after the procedure, which I understand can be a barrier for some people.

At Nuvance Health, we maintain each patient’s privacy and dignity during the procedure. Patients wear a gown and a blanket covers them during the procedure. The gastroenterologist barely touches the patient other than inserting and removing the colonoscope (a thin, flexible tube with a light and video camera at the end of it) into the colon, because they look at the inside of the colon on a monitor.

For anyone who feels embarrassed about having a colonoscopy screening, it is important to validate how they feel, let them know they are not alone and give them privacy and space to make a decision that is best for them. Tell them you will maintain their confidence if they ask you to drive them to and from the procedure.

I am nervous about the colonoscopy screening prep.

No one wants to do a colonoscopy screening prep! It might help to think about the prep as an opportunity to have a fresh start to digestive health by cleaning out your colon. Plus, if your colonoscopy screening is normal, you only have to do the prep once every 10 years.

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Sure, modifying your diet and having more frequent trips to the bathroom can be annoying. However, isn’t just a few days of annoyance worth it, compared to years of good colon health and peace of mind? You can also plan a delicious meal to have something to look forward to after the procedure.

There are different prep options nowadays that most people tolerate well. At Nuvance Health, we recommend individuals follow a low-residue diet three days before the colonoscopy screening by avoiding high-fiber foods, seeds and nuts. Clear liquids are only required one day before the procedure.

There is an option to drink less of the prep and more water. There is also a split dose option, where you drink some prep the night before and the rest the morning of the procedure. You can also have a flavored prep.

I do not know what happens during a colonoscopy screening.

Colonoscopy screenings are exceedingly safe, painless procedures. Doctors have been performing colonoscopy screenings since 1969 and the procedure has an extremely low complication rate.

Colonoscopy screenings are painless because the patient is under anesthesia. At Nuvance Health, a board-certified anesthesiologist or nurse anesthetist keeps patients comfortable during the procedure.

Some people worry about what the doctor might find during the colonoscopy. If your gastroenterologist finds a precancerous polyp, they will remove it during the procedure. Nowadays, we are finding fewer cancers during colonoscopies because more people are being screened and having precancerous polyps removed. At Nuvance Health, if your doctor finds cancer, rest assured knowing they will connect you to the best possible care.

Ultimately, many of my patients tell me having a colonoscopy was the greatest nap they ever had.

If someone you care about is resistant to having a colonoscopy screening, it is important to first listen and respect how they feel. Then, share how you care about them and why a screening colonoscopy is a huge opportunity to prevent colorectal cancer. I have more than 30 years of experience and know firsthand that even the most reluctant people are surprised by how well they tolerate colonoscopies.

Dr. Estabrook is board certified in both internal medicine and gastroenterology. He cares for people with a broad array of acute and chronic gastrointestinal conditions. He has performed thousands of endoscopic procedures, including colonoscopy screenings. Book now with Dr. Estabrook.

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