1. Bean, Kathy B. PhD, RN, CGRN, APRN, BC, Editor

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I have just completed my first screening colonoscopy and I am here to tell you-I did it and you should too!! I elected to have my screening done a few years before the recommended 50 years-of-age because I have a family history of colon cancer. My maternal grandfather and paternal grandmother both died of colon cancer, my grandfather at middle age. In addition, my father has had polyps "harvested" every 3 years during his many surveillance colonoscopies, so I knew chances were good I would inherit the family legacy. My women's health specialist has been encouraging me for several years to have the procedure and this year, my spouse and I decided to follow through.

Figure. Kathy B. Bea... - Click to enlarge in new windowFigure. Kathy B. Bean, PhD, RN, CGRN, APRN, BC

My experience was typical of most of our patients. The bowel prep was the worst part and the moderate sedation was divine!! I awoke after a heavy sleep to find not only did I have five polypectomies; one polyp was approximately 1 cm. in size. As I realized what this might have meant had I waited until age 50, I was grateful I had elected to pursue screening earlier than the recommended age. I have always been an advocate of colorectal cancer screening, but now, I am passionate!!


Colorectal cancer is the second leading cause of death from cancer in the United States. Age and health history are important factors in determining risk and it occurs more often in men than women ( Screening at age 50 for average-risk adults is recommended by both the U.S. Preventive Services Task Force and the American Cancer Society. Currently, there are five common methods of screening: fecal occult blood test, sigmoidoscopy, colonoscopy, barium enema, and digital rectal exam (not recommended as a stand-alone test). In addition, virtual colonoscopy and DNA stool testing are in developing stages as additional screening tools.


The Goals for Healthy People 2010 ( include specific objectives related to colorectal cancer:


* Increase to 50% the proportion of adults ages 50 and older who have had an fecal occult blood test within the past 2 years.


* Increase to 50% the proportion of adults ages 50 and older who have ever had a sigmoidoscopy.



No Healthy People 2010 target has been set, however, for the proportion of adults who should receive colonoscopy screening.


Unfortunately, statistics from the National Cancer Institute ( have found people with lower educational levels and income, and those without health insurance are less likely to be screened for colorectal cancer. In fact, colorectal screening rates for the U.S. in general are low, yet colorectal cancer is one of the most preventable cancers!!


For gastroenterology nurses, colorectal cancer screening should be at the top of our list of educational priorities for patients and the public. There are excellent resources available through the American Cancer Society, National Cancer Institute, Colon Cancer Alliance, and Katie Couric's National Colorectal Cancer Research Alliance, to name a few. The SGNA Website also has excellent cancer-related links and Gastroenterology Nursing has published many excellent articles focusing on colorectal cancer and prevention.


Clearly, gastroenterology nurses should be at the forefront of those pushing for routine insurance and Medicare coverage for screening, diagnostic, and surveillance procedures as well as advocating for more research dollars to assist in important scientific work (both medical and nursing) towards curing, treating, and managing colorectal cancer. Most importantly, however, I believe we should make it a priority for each member of the gastroenterology team to follow the recommended guidelines and obtain screening when indicated. It's too easy to forget about ourselves when we are focused on others!! But, we know what needs to be done. We have the resources to do it. I'll say it again-I did it and you should, too!! Get screened.