The standard colon cancer screening has been the colonoscopy procedure. The problem with the procedure is the side effects of conscious sedation. I have had a couple of patients that have had significant cognitive problems after the colonoscopy due to conscious sedation. These are similar to the cognitive deficits that can offer after major surgical procedures.

One of my patients who had atrial fibrillation was scheduled for colonoscopy at an outpatient facility. At the end of the procedure, she went into full respiratory arrest. Fortunately, the doctors were able to get her to the hospital and she recovered..

For approximately 10 years, we have had a technique called CT colonoscopy, which not only gives a better picture of the colon, it does not require conscious sedation. The U.S. Preventive Services Task Force (USPSTF) has finally deemed that the CT colonoscopy is an acceptable option for colorectal cancer screening.

This paves the way for Medicare reimbursement and for broader coverage by private insurance payers. The data on this decision was published by the General American Medical Association on June 15, 2016.

Another technique that is being developed is the use of MRI for colonoscopy rather than a CT. This procedure avoids the risks of radiation from the CT scan. Hopefully, the technology for the MRI colonoscopy will be approved in the near future, rather than taking over 10 years as it did for approval of the CT colonoscopy.