Waiting for colonoscopy!

[Spike]

i heard healthysg will give you a free colonoscopy when you hit 50.
can go private one?

By the time I get this free colonoscopy.. maybe I die liao.

I just got a referral from polyclinic!

 

[plaingrain]

I wish you well @Spike .
I'm seeing a specialist in October and probably getting a scope done, your thread helps me understand a little more about what to expect. Thank you.

 

[Roastduck]

That's a very good question, and the answer is yes—but with an important qualification.


The pathology report shows that you had four sessile serrated lesions (SSLs). These are recognized precancerous lesions, but they do not mean that you were destined to develop colon cancer.


Think of it like this:

Stage	Your situation
Normal colon	Not anymore
Small sessile serrated lesion	This is where you were
Large SSL with dysplasia	You were not here
Early colon cancer	No
Advanced colon cancer	No

Your lesions were found at Stage 2, and they were removed before they progressed further.

What would have happened if you had never had a colonoscopy?​

No one can say for certain, but there are three possibilities:

1. Some lesions might never have progressed.
   • Not every SSL becomes cancer.
2. Some might have slowly enlarged over many years.
   • As SSLs grow, the chance of developing dysplasia and eventually cancer increases.
3. One or more could eventually have become cancerous.
   • This is exactly why SSLs are removed when found.

So it's fair to say that your future risk of colorectal cancer would have been higher if these lesions had been left in place, but it is not correct to say that you would definitely have developed cancer.

The encouraging part​

Your pathology report contains two very reassuring findings:

• No dysplasia (no precancerous cellular changes beyond the lesion itself).
• No malignancy (no cancer).

That means they were caught early.

How much has your risk changed now?​

By removing these lesions, your gastroenterologist has likely substantially reduced your future risk of colorectal cancer. Colonoscopy is one of the few screening tests that is both diagnostic and preventive—it finds lesions and removes them before they can become cancer.

Looking ahead​

Because you've now been shown to form SSLs, you're someone who benefits from surveillance.


The plan is straightforward:

• Repeat colonoscopy in 3 years.
• Remove any new lesions while they're still small.
• Continue healthy lifestyle measures (maintaining a healthy weight, regular exercise, a high-fibre diet, limiting processed and red meat, and avoiding smoking).

If you keep up with surveillance, the outlook is generally very good.

My overall impression​

If I had to summarize your situation:

• One year ago, your biggest health concerns were blood pressure, cholesterol, glucose control, and gout.
• Now, your blood pressure has normalized, your HbA1c has improved, your liver and kidney function are excellent, and your blood counts are normal.
• The colonoscopy found something important—but it also prevented a potential future problem by removing precancerous lesions before they had progressed.

So I don't view this as bad news. I view it as a successful screening test that identified a risk early enough for effective prevention. The key is to stay engaged with the recommended follow-up rather than assuming the problem has gone away permanently.

Is time to do some changes to your diets.
Do consider to change to wholesome natural home cooked food as much as you can.

 

[Spike]

Well folks, good for your knowledge.

This is actually one of the most interesting areas in colorectal cancer research because we don't know the exact probability that an individual SSL will become cancerous. We do know that SSLs are bona fide precancerous lesions, but many never progress, and those that do often take years.

What we know from studies​

Finding	Evidence
About 15–30% of colorectal cancers arise through the serrated pathway (SSLs and related lesions).	This is well established in the literature.
Most SSLs never become cancer.	The majority remain stable or grow slowly, particularly when they are small and lack dysplasia.
The risk rises substantially once dysplasia develops.	Dysplasia is considered the major step before invasive cancer, and progression can accelerate after that point.
Removing SSLs greatly reduces future cancer risk.	Surveillance colonoscopy is associated with a marked reduction in colorectal cancer incidence after serrated lesions are removed.

Applying this to your pathology​

Your report shows:

• 4 sessile serrated lesions (SSLs)
• All were <5 mm
• No dysplasia
• No malignancy

That combination is actually the most reassuring end of the SSL spectrum.


If we ranked SSLs by risk:

Lesion	Relative risk
Tiny (<5 mm), no dysplasia	Lowest
5–9 mm, no dysplasia	Low–moderate
≥10 mm	Higher
Any SSL with dysplasia	High
Invasive cancer	Established cancer

Your lesions fall into the green category.

An interesting modelling study​

A recent colorectal cancer modelling study estimated that, without screening, almost 96% of SSLs that eventually become cancers first grow beyond 10 mm. Only a very small fraction are predicted to become cancer while still under 5 mm.


That's important because:

Yours were all removed when they were under 5 mm.

In other words, they were detected at a very early stage.

What is your risk now?​

There are two separate questions:

1. Risk from the lesions that were removed?
   • Essentially eliminated if they were completely excised.
2. Risk of developing new SSLs in the future?
   • Higher than someone who has never had an SSL, which is why surveillance is recommended.

Recent long-term data show that after serrated lesions are identified and managed, the 10-year cumulative incidence of colorectal cancer remains low, and repeated surveillance colonoscopies are associated with a substantial further reduction in risk.

My assessment of your situation​

Your pathology has three features I particularly like:

• Tiny lesions (<5 mm)
• No dysplasia
• Completely removed

The feature I don't like is:

• There were four SSLs at age 44.

That tells me you're someone who forms serrated lesions, so I completely agree with your gastroenterologist's recommendation for a 3-year surveillance colonoscopy.


If you continue with surveillance and any future SSLs are removed while they're still small, your risk of colorectal cancer should remain much lower than if the lesions had been left undetected. That's exactly why colonoscopy is such an effective preventive tool in people who develop these types of polyps.

 

[Spike]

Is time to do some changes to your diets.
Do consider to change to wholesome natural home cooked food as much as you can.

Thanks boss. No worries. I do eat home cooked food.

I wish you well @Spike .
I'm seeing a specialist in October and probably getting a scope done, your thread helps me understand a little more about what to expect. Thank you.

Well...I guess I need to thank the gentleman who suggested that I should go for a colonoscopy early.