What is a Colonoscopy?
A colonoscopy is a routine, cancer-prevention screening that uses a flexible hose with a camera attached to view your colon and large intestine. If the doctor sees a risky-looking polyp, it will be removed during the procedure and tested with a biopsy. Because the risk of colon cancer increases with age, most people begin getting colonoscopies at 50 years old.
Why is it important to get a colonoscopy?
A colonoscopy is intended not to just find cancer, but to prevent it from developing. Colon cancer nearly always starts as a a ‘polyp.’ A colon polyp is a small growth of cells in the lining of the colon. If left to grow, over many years it can become colon cancer. Polyps have no symptoms, so a colonoscopy is the best chance to remove them when they are small, before they have a chance to grow into a malignant tumor.
What’s Different about Colonoscopies at UHH?
Having your colonoscopy at Upland Hills Health means a more comfortable experience during and after your procedure. The difference is both in our anesthesia process and in the experience our physicians bring to the procedure.
Because we have a team of Certified Registered Nurse Anesthetists (CRNAs) who are highly trained and skilled in airway management, we are able to use anesthesia procedures that allow you to sleep deeply during your procedure (with no chance of waking up during the colonoscopy) and wake up more refreshed, with little to no chance of nausea and no memory of the procedure. Our CRNAs monitor you during your surgery, adjusting your medication as needed to ensure your comfort during your procedure and your waking experience. Patients often wake up and ask if the procedure has begun yet!
Combined, Drs. Ryberg and Linebarger perform nearly 400 colonoscopies a year.
What happens next if a polyp is removed?
Colon polyps are very common. As we age, our likelihood of developing polyps increases. At age 60, one-third or more of people will have at least one polyp. Most polyps are benign, or non-cancerous.
If the doctor finds a polyp during your colonoscopy, he will remove it and send it for testing to see if it is cancerous. The results of that test come back within a week.
If you have a polyp removed during your colonoscopy, it won’t affect what you can eat or what you can do. Just be sure to call your doctor if you experience any rectal bleeding.
Once the polyp test results come back to your doctor, he will analyze them and call you with the results. The next steps depend on whether your polyps are benign, precancerous, or cancerous, as well as your personal and family history.
-
If they’re benign, you likely won’t need further treatment.
-
If they’re precancerous, there’s a good chance that colon cancer won’t develop because the polyp was removed.
-
If they’re cancerous, colon cancer IS treatable and your doctor will talk to you about a plan.
When you have polyps removed, your doctor will talk to you about a schedule for future colonoscopies. How soon you need to return for follow-up depends largely on the size of the polyps found in the first exam, and other factors, such as your personal medical history and that of your relatives.
Quality Measures
Most people who are at average risk for colon cancer only have to undergo colonoscopy every 10 years. It is extremely important that your physician is thorough and diligent in performing the procedure. Withdrawal Times and Adenoma Detection Rates are two measures that can indicate the thoroughness and skill of the physician.
What is Withdrawal Times?
Withdrawal time is the amount of time the doctor spends viewing the colon as the instrument is withdrawn during a colonoscopy. You want the physician performing your colonoscopy to do a complete and thorough exam. The more time spent viewing during the withdrawal of the scope can increase the number of polyps found and removed. A minimum 6 minute withdrawal time is currently the standard of care. UHH averages 11.96 minutes and is performing better than the standard.
| Q3 ’21 | Q4 ’21 | Q1 ’22 | Q2 ’22 | Q3 ’22 | Q4 ’22 | Q1 ’23 | Q2 ’23 | |
| UHH Time in Minutes | 13.92 | 12.28 | 12.42 | 12.7 | 11.51 | 11.77 | 11.02 | 10.13 |
| Minimum Time Standard in Minutes | 6 | 6 | 6 | 6 | 6 | 6 | 6 | 6 |
What is Adenoma Detection Rate?
An adenoma is a benign tumor or growth that is identified and can usually be removed during a colonoscopy. Most colon cancers develop from adenomatous polyps. If a harmless adenoma is left to grow in the colon, it may become malignant over time.
Adenoma detection rate (ADR) is the national benchmark on quality for screening colonoscopy. The detection rate is the percent of the number of patients having a screening colonoscopy who have at least one adenoma, or polyp, detected. ADR should be least 15 percent in women and 25 percent in men to show the most thorough exam. Physicians take great pride in their ADR because it is a direct measure of the effectiveness of the colonoscopy that they offer. Dr. Ryberg averages a 40.8% detection rate and is performing better than the standard of care.
| Q3 ’21 | Q4 ’21 | Q1 ’22 | Q2 ’22 | Q3 ’22 | Q4 ’22 | Q1 ’23 | Q2 ’23 | |
| UHH Percent | 44.1% | 30.0% | 36.7% | 55.3% | 46.3% | 40.0% | 31.0% | 42.7% |
| Minimum Standard of Care | 25.0% | 25.0% | 25.0% | 25.0% | 25.0% | 25.0% | 25.0% | 25.0% |
