I am in the process of looking for a qualified professional to perform my first colonscopy. I am at risk because my sister had colon cancer at age 14. She is now 36 and has a colostomy bag. I spoke with a doctor here in NYC and she informed me that she has had 3 experiences where perforations took place and one person actually died (the person is already ill for other things). I am apprehensive about having her perform my colonoscopy. Is my concern well founded? What credentials should I ask for as I look for a doctor to perform this?
Timothy C. Hoops, MD, Clinical Assistant Professor of Medicine in the Gastroenterology Division at the University of Pennsylvania and Director of Gastroenterology at Penn Medicine at Radnor, responds:
I would agree that you should have a colonoscopy as you are at much higher risk for colon cancer. I also understand your concern about the risks of the procedure. In all the hub-bub about screening colonoscopies that has been presented in the press, this issue is often overlooked.
In general, the risk is very small. The medical literature suggests a risk of between 1 in 500 and 1 in 10,000. Suffice it to say that your risk for cancer is significantly greater although still small. Your doctor was particularly open and straightforward with you; many are not so detailed. That does not imply lesser skills. One would have to know the number of procedures she has performed and the aspects of the individual cases as there are numerous things that may have predisposed to perforations. The risk in a healthy young person is very small.
As to credentials, I would make sure your physician has been formally trained to perform colonoscopies in an accredited program, has performed a large number of them (preferably at least several hundreds), and is board certified by their specialty. You should feel confident that your physician is fully capable of doing the procedure and in the unfortunate event of a complication, is able to recognize and deal with the situation.
To summarize, while you should be aware that there are complications with colonoscopy, as there are with any medical intervention. There are also risks of not having the procedure. These generally outweigh the risks of the procedure.