No one should die of embarrassment. But for many people who can't get past the uncomfortable thought of getting a colonoscopy that may well be the case.

The simple truth is that colonoscopies can prevent death from colon cancer by detecting early forms of the disease. It is the best test to do so.

"While other colon cancer screening tests are available, a colonoscopy is the only method proven to decrease the risk of colon cancer by 85 to 90 percent," said Dr. Bruce Waldholtz, a Chesapeake Regional Medical Center gastroenterologist who practices with Gastroenterology Associates.

Current guidelines recommend that everyone have a baseline colonoscopy by age 50, but certain risk factors, including family history, may require getting one at an earlier age. Other risk factors include age, ethnicity, diet and smoking.

In the last decade, as media attention has helped to demystify and reduce the embarrassment of the screening and physicians have made the screenings part of routine health maintenance, the number of people getting colonoscopies has nearly doubled from 30 to 55 percent. The number of deaths due the disease has also declined.

However, colon cancer remains the third most commonly diagnosed cancer in the United States and the second leading cause of cancer-related deaths, according to the American Cancer Society. And while it may be one of the deadliest cancers, colon cancer is also one of the most preventable.

"Colon cancer screening is life-saving," said Waldholtz.

Most colonoscopies are performed in physicians' offices under anesthesia. During the procedure, the physician looks inside the colon and large intestine using a flexible camera called a "colonoscope," which can detect and remove polyps. About 90 percent of all colon cancer develops from these polyps.

The beauty of the procedure, noted Chesapeake Regional's Dr. Pramod Malik, is that "Colonoscopy is widely accepted as the best method to prevent colon cancer because it allows the physician to both identify and remove polyps at the same time."

For more people, the preparation for the procedure is the worst part. "Contrary to common perception," said Malik, who practices with Gastroenterology Associates of Tidewater, "the procedure rarely is a painful experience and studies are under way to devise better methods to prep the colon prior to the examination. These include ingesting a lower volume of better tasting liquids that are better tolerated."

While the American College of Gastroenterology, the American Society for Gastrointestinal Endoscopy and the ACS agree that a colonoscopy is the best way to detect a precancerous polyp or cancer, it is not the only screening method available.

Some of the newer methods for colon cancer screening include a camera pill for the colon and DNA stool testing, in which a stool sample is examined for abnormal proteins excreted from polyps or cancers. Both of these tests require a colonoscopy if any abnormalities are detected.

When a colonoscopy is needed, finding the right physician is essential. It is important to ensure that a certified gastroenterologist performs the procedure. Patients should ask questions.

"You should not be afraid to ask your physician about their individual polyp detection rate, which should be at least 25 percent, and the amount of time taken to visualize the colon on the way out, which should be approximately six minutes or more on average," said Malik. "It is also important that the doctor who performs your colonoscopy has a reasonable practice volume of colonoscopies every year. At minimum, this number should be 100, but several hundred is preferred."

Consult your physician for more information, or to find a gastroenterologist visit www.chesapeakeregional.com .