Colon Health Centers the smart way to screen
of America, LLC

Frequently Asked Questions: For Patients

Patients  /  Primary Care Providers  /  GI Physicians  /  Payors

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Why is Colon Cancer Important to me?

Colon Cancer is the second leading cause of cancer deaths (2007 estimate: 52,000), and the third leading cause of newly diagnosed cancers (2007 estimate: 154,000) in the US. The American Cancer Society states that as many as 90% of all Colon Cancer cases and deaths are preventable with early detection through timely screening. Tragically, less than 50% of the eligible population in the US gets appropriate testing for Colon Cancer. Therefore, tens of thousands of Americans are dying needlessly from Colon Cancer every year.

Don't let yourself or a loved one become a statistic. Get screened for Colon Cancer now!

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What is the Mission/Philosophy of Colon Health Centers (CHC) of America?

We at CHC America are passionate in our quest to eliminate Colon Cancer in Americans. While it is estimated that as many as 90% of Colon Cancer deaths could be avoided by appropriate screening, tragically, fewer than half of Americans are getting screened. Tens of thousands of Americans are dying needlessly from Colon Cancer every year in this country. Plainly stated, the American healthcare system is failing miserably with respect to Colon Cancer screening.

The mission of CHC America is to change this tragic reality by revolutionizing the way we screen for Colon Cancer in this country. Our goal is to screen every American for Colon Cancer and we will not rest until this is accomplished. We believe that if Colon Cancer screening is made simple, convenient, comprehensive, and noninvasive, many more Americans will get appropriate screening. The innovative strategy of CHC America, bringing together the two best Colon Caner screening methods and allowing patients to benefit from the advantages of both, accomplishes the need to make screening simple, convenient, comprehensive, and noninvasive.

Satisfied patients mean more patients screened, which means more Colon Cancers prevented. This is the driving philosophy and passion behind CHC America's strategy.

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Who should be screened for Colon Cancer?

The American Cancer Society recommends that average-risk adults should begin Colon Cancer screening at the age of 50 years and to continue periodically throughout life. Your doctor may recommend Colon Cancer screening for you prior to age 50. One reason for this earlier recommendation is if your doctor determines that you are at higher than average risk for Colon Cancer.

Some of the characteristics of higher risk individuals include: 1) a personal history of polyps or colon cancer in the past; 2) a history of colon cancer or polyps in a family member (first degree relative); and 3) a personal history of inflammatory bowel disease; or 4) a history or suspicion of certain higher risk hereditary conditions [eg. hereditary nonpolyposis colon cancer (HNPCC) or familial adenomatous polyposis (FAP)].

For example, if told that a first degree relative (parent, sibling) has a history of polyps, your doctor should recommend colon cancer screening earlier (eg. age 40). The intervals for subsequent screening depend on your history and the results of your initial screening.

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What are the options available for Colon Cancer screening?

Current medical guidelines often lag several years behind medical research. As of January 2008, there are four officially recommended methods for Colon Cancer screening:

  1. Fecal occult blood test (FOBT): a test to detect the presence of blood in the stool
  2. Flexible Sigmoidoscopy (Flex Sig): a scope test looking at the first 24 in. of the colon only
  3. Double-contrast barium enema: (DCBE): An x-ray test looking at a barium-filled colon
  4. Traditional (optical) Colonoscopy (OC): a scope test looking at the entire length (60-70 in.)of the bowel

While all four of these tests are "recommended" by the major medical guidelines, only traditional colonoscopy is highly sensitive for detecting polyps and cancers (approximately 90% sensitive). The other recommended tests are significantly less sensitive (50-60% sensitive--meaning it might miss as many as half of the polyps and cancers that might be present in the colon). Therefore most physicians currently recommend traditional colonoscopy for screening.

Early in 2008, the American Cancer Society is expected to issue updated colon cancer screening guidelines, which will include virtual colonoscopy/CT colonography as a recommended screening test.  This updated recommendation will help millions of additional Americans receive the colon cancer screening they need. 

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Why not just get a traditional colonoscopy then?

Traditional colonoscopy is a good screening test because it visualizes the entire colon, is highly sensitive, and enables the physician to remove polyps and early cancers during the same procedure.

Traditional colonoscopy has some major drawbacks, however. It is an invasive test, and can be painful without sedation or anesthesia. Because anesthesia is usually given during colonoscopy, the patient must spend time in the recovery room while the anesthesia wears off. Furthermore, the patient is not allowed to drive for 24 hours following the exam and will often miss work that day. Therefore, the rest of the day is usually lost after a traditional colonoscopy.

Also, since traditional colonoscopy is an invasive test, it carries risks to the patient. Besides the well-know risks of anesthesia, traditional colonoscopy also carries the risk of bowel perforation. This serious potential side effect occurs in approximately 2 patients for every 1000 colonoscopies, and often results in the need for emergency surgery.

Since only 20-30% of average risk patients will have abnormalities that need to be removed by traditional colonoscopy, it is unfortunate if the other 70-80% of patients are forced to endure the risks and inconveniences of this invasive test.

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What is Virtual Colonoscopy (VC)?

VC, also known as CT Colonography, is is a revolutionary and technologically-advanced new screening test for Colon Cancer. VC is an imaging test that is performed by an advanced CT scanner. Images of the patient's abdomen are taken by the CT scanner. With special software, these images are put together to create a three-dimensional image of the colon. This 3-D image of the colon provides the same view of the inside of the colon that is seen by traditional colonoscopy. In fact, the views provided by VC, in many ways, are even better than those seen by traditional colonoscopy.

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Why is Virtual Colonoscopy (VC) such a breakthrough screening test?

VC is a non-invasive test. It does not require the insertion of an endoscope throughout the colon. It is quick--completed in about 10-15 minutes. Further, it does not require sedation or anesthesia. Therefore the patient is able to immediately resume all activities, including driving and work.

Recent studies of VC show that it is as sensitive for detecting polyps and cancers as traditional colonoscopy. In fact, in many ways, the images provided by VC are even better than those seen by traditional colonoscopy. This is because VC can often see corners, folds, and nooks and crannies of the bowel easier and better than traditional colonoscopy.

Furthermore, unlike traditional colonoscopy, which only sees the inside of the colon, a VC also provides images of the rest of the abdomen. While VC images are not a substitute for a complete abdominal CT scan (if one is indicated for other reasons), these VC images can often detect early cancers and other abnormalities in abdominal organs. Many people have been cured of abdominal cancers before they developed symptoms because they were detected early by VC.

With VC, patients not only receive an easy, safe, and very sensitive screening test for Colon Cancer, but they also get a chance to detect any other early cancers that might be present in the abdomen.

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What are the major limitations of VC?

While VC is a fabulous new technology, and a test that most patients prefer over traditional colonoscopy, there are a few limitations. First, there is no polyp removal capability with VC. If polyps are detected (approximately 20-30% of average risk patients), a traditional colonoscopy needs to be performed to remove them.

Second, patients who undergo VC will need to perform a 12 hour, pre-test colon preparation (laxatives), exactly like patients who undergo traditional colonoscopy.

The innovative process employed by Colon Health Centers of America greatly reduces the impact of these two limitations. The CHC America process allows patients to fully benefit from all the many advantages of VC, while greatly reducing the impact of the two limitations. (See What is so innovative about the Colon Health Centers of America Colon Cancer screening process?)

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What is so innovative about the Colon Health Centers of America?

The CHC America Colon Cancer screening process represents the ultimate in patient convenience, comprehensiveness, and safety. The patent-pending CHC America process brings together the best aspects of VC and traditional colonoscopy, and minimizes the limitations of both, in a way that cannot be replicated elsewhere.

The majority of average risk patients (70-80%) who present for screening will not be found to have colon polyps or other abnormalities that would need to be removed. It is unfortunate that these patients have to undergo the additional risk and inconvenience of a traditional colonoscopy, only to find a "clean" colon.

On the other hand, 20-30% of patients who receive a stand-alone Virtual Colonoscopy will have polyps and early cancers detected on VC that will need to be removed. It is unfortunate that these patients first need to undergo a colon prep for the VC, and later will be notified that they will have to schedule an appointment for a traditional colonoscopy to remove the abnormalities, and undergo a second colon prep all over again! These patients have every right to be angry!

The CHC America process streamlines and eliminates these problems by creating a "Colon Health Center"--a Virtual Colonoscopy imaging center together with traditional colonoscopy endoscopy center.

Patients arrive at the Colon Health Center after performing an overnight colon prep. They receive their VC, which takes approximately 10-15 minutes. The VC images will be immediately sent to the CHC America reading site, staffed by the most experienced and expert VC readers in the country. Within one hour's time, the patient's VC reading will return and the patient will be notified whether or not they have any colon abnormalities. If they happen to be one of the lucky 70-80% of average risk individuals, they are done and can immediately resume all activities.

If they are among the 20-30% of individuals with polyps or other abnormalities, they will be immediately directed to the co-located endoscopy center where they will undergo a traditional colonoscopy and remove the abnormalities.

No need for a second prep! No second day off work! Pure convenience designed around the needs of patients.

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Why choose Colon Health Centers of America over stand-alone radiology/imaging centers?

VC is a test that is also offered at stand-alone radiology and imaging centers. But the vast majority of these centers will have no capability to follow-up with a traditional colonoscopy. Therefore, patients receiving VCs at these centers will be forced to take a second day off work and undergo a second colon prep! Who would want to take that risk?

Furthermore, the VCs done at stand-alone radiology/imaging centers will likely be read by the local staff radiologist. While they may be fine radiologists, they will typically be generalists who read chest x-rays, MRIs, mammograms, ultrasounds, etc. along with VCs. The radiologists who read CHC America studies are national experts in VC. In many cases, VC is all they read--all day, every day. Studies have clearly shown that experience dramatically improves one's ability to read VCs. With CHC America, you will only have the best VC readers in America reading your study.

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What can I expect at a screening appointment?

You will arrive at the Colon Health Center after taking an overnight colon prep. You will be checked in by the receptionist, or at one of our computer check-in kiosks. You will be shown into a private dressing room where you will be asked to remove your outer clothing and put on a gown. You will remain in the comfortable, private dressing room with a flat-panel TV briefly watching a video of what to expect during the VC. After watching the short video, you will be brought from the dressing room via a private hallway into the VC room by the CHC technician.

In the room, you will be placed on the VC table. A small tube will be inserted just into your rectum (this is not painful). The tube is used to insufflate (blow in) carbon dioxide gas into the colon to gently inflate it and allow for better images. Occasionally patients will report a brief "bloating" feeling related to this insufflation of air, but it is not uncomfortable for the majority of patients, and dissipates immediately following the test.

You will then be passed through the CT scanner quickly, once on your back and once on your stomach. The whole process takes less than 15 min. You will then be taken back to your dressing room where you can get dressed in your street clothes. From there you will be given two options for the 45-60 minute wait for your results: 1) You may wait in the comfortable waiting room and watch TV or read a newspaper, or 2) you may provide a cell phone number where you can be reached, and leave to run errands, etc. for an hour. You must not have any food, drink, or anything by mouth during this waiting time. (Doing so could prevent you from receiving a colonoscopy that day, if you happened to need one.)

If you are found to have no abnormalities on your VC reading, your screening is complete. You may drive yourself home, to work, etc. and resume all activities, including eating your normal diet. If your VC reading finds significant polyps or other abnormalities that need to be biopsied and/or removed, you will be directed to the endoscopy center part of the Colon Health Center.

At least one room of the endoscopy center is dedicated to CHC America patients who have positive VC findings. At the endoscopy center, you will undergo a preoperative interview and exam and an intravenous line will be placed. You will meet one of the highly experienced and board-certified gastroenterology physicians who will perform the colonoscopy. You will also be asked to arrange for a ride home, as you will not be allowed to drive after the test.

Once in the room, the anesthetist will administer sedatives or anesthesia, and the colonoscopy will be performed. You will wake up immediately after the test and be taken to the recovery area. Your physician will review the findings and follow-up plan from the colonoscopy. All reports will be sent to you and your primary physician.

You will be discharged with your ride and will be told not to drive until the following day and to rest for the remainder of the day.

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Is there radiation involved in VC?

Yes, there is radiation exposure with any x-ray or CT scan. Fortunately, with advances in CT technology the radiation exposure from VC is minimal and is similar to the radiation exposure that one encounters by simply being outdoors for a period of time. Equipment used at CHC America centers is the latest technology and therefore performs VC with the smallest possible radiation exposure.

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Where else can I receive a similar comprehensive, same-day process?

The short answer is "nowhere". CHC America has a patent pending with the US Patent and Trademark Office on their innovative and comprehensive, same-day screening methodology in the community. Furthermore, CHC America has a passion for improving patient satisfaction with its Colon Cancer screening process. After all, satisfied patients are more likely to get screened and therefore prevent colon continues to improve and perfect this patient-centered approach to Colon Cancer screening.

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