Video Credit: NYULangone Medical Center

Colon cancer and rectal cancer can be prevented. Through screening, a normal (benign) polyp called an adenoma can be removed before it becomes cancerous. Screening can also detect colorectal cancer early — when it is most curable.

All adults (men AND women) over the age of 50 are at risk for colorectal cancer and should be screened for adenomatous polyps and cancer. Some with higher risk should work with a doctor to develop an individualized screening plan.

What are your screening options?

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Video Credit: Paul J. Linmburg, M.D.

When & how should I be screened for colorectal cancer?

FLEXIBLE SIGMOIDOSCOPY

A physician uses a sigmoidoscope to view the sigmoid colon and the rectum. Less than half of the large intestine and all of the rectum can be seen. An enema is done to clean out the lower part of the colon and the rectum; some doctors require that the entire colon must be cleaned out. Polyps can be removed with the sigmoidoscope.  Should be done in combination with gFOBT or FIT test.

COLONOSCOPY

A physician uses a colonoscope (longer than a sigmoidoscope) to view the entire colon and the rectum. The entire colon must be cleaned out in order to perform a colonoscopy.  Polyps can be removed with the colonoscope. This is often considered the “gold standard” for colon screening.

DOUBLE-CONTRAST BARIUM ENEMA (DCBE)

The DCBE is an x-ray of the colon and rectum that highlights abnormal areas.  The entire colon must be cleaned out.  The contrast solution is inserted through the anus and then drained.  Air is pumped into the colon, and x-rays are taken.  If abnormalities are found, the appropriate diagnostic procedure is performed.

CT COLONOGRAPHY (VIRTUAL COLONOSCOPY)

Colon screening through CT colonography is a non-invasive, advanced CT scan of the colon and rectum that produces 2 and 3-dimensional images of the colon and rectum that allows a doctor to look for polyps or cancer. The entire colon must be cleaned out. Air is pumped into the colon and the CT scan is taken.  If abnormalities are found, the appropriate diagnostic procedure is performed.  Polyps smaller than 5mm or less are not identified for removal.

FECAL OCCULT BLOOD TEST (GFOBT)

The gFOBT test is an in-home test used to detect blood that cannot be seen by the naked eye occurring in or on bowel movements. Stool is placed on a test strip, and sent to a facility that tests it for blood. Test results of either “positive” or “negative” determine if bleeding is occurring; however, it will not indicate the cause. To provide accurate samples, patients need to follow drug and dietary restrictions. The test is typically returned via mail pouch to the doctor or lab.  If a test result is positive, a diagnostic colonoscopy should be performed.

FECAL IMMUNOCHEMICAL TEST (FIT)

The FIT test works like the gFOBT test, however unlike the gFOBT, there are not drug and dietary restrictions.  The FIT is better at detecting blood than the gFOBT.

STOOL DNA TESTS

These tests look for abnormal sections of DNA in the stool rather than blood in the stool. A kit is provided, and the stool is mailed to a lab that looks for DNA.

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