The Difficult Colonoscopy

Colorectal cancer is the most common cause of cancer-related death among nonsmokers in Canada (1) and is the second leading cause of cancer mortality overall. It is estimated that in 2007, approximately 21,000 Canadians will be diagnosed with colorectal cancer and that nearly 9000 will die from it (2). For this reason, the Canadian Task Force on Preventive Health Care recommends screening patients over the age of 50 who are at average risk for colorectal cancer (3). Dr Todd N Witte Optical colonoscopy may not be a feasible initial screening test for the nation’s health care budget to absorb at present; however, Canadian physicians trained in endoscopy are performing increasing numbers of colonoscopies, whether resulting from a referral after fecal occult blood testing or other screening modalities (4). In British Columbia alone, approximately 69,000 colonoscopies were performed last year (5).