Colorectal Cancer Screening: Understanding Your Options
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Imagine this: You’re at the doctor’s office, and they tell you that you need a colonoscopy or other type of colorectal cancer screening.
If you’re like most people, you might not see this as good news. And I completely understand that. However, as a gastrointestinal (GI) oncologist (a doctor who specializes in the diagnosis and treatment of GI cancers), I can assure you this screening is more than merely necessary—it’s an opportunity.
Colorectal cancer screenings do more than just help detect cancer early. They can also help prevent it.
Screenings offer big benefits
Colorectal cancer—also called colon cancer—is a leading cause of cancer-related death. But, as I explain to my patients, early detection can make an enormous difference.
When colorectal cancer is diagnosed and treated early, it usually can be completely cured. In fact, in this scenario, the five-year survival rate is 90%. This is a great statistic and a testament to the effectiveness of preventive colorectal cancer screening.
That’s one reason I encourage everyone to stay up-to-date with colorectal cancer screenings. Another: Screening can actually help to prevent this common cancer.
To understand how, it helps to start with the basics. Colorectal cancer is cancer that begins in the colon (large intestine) or the rectum (last section of the colon). Most of the time, it develops from small growths, called polyps, in the lining of the colon or rectum.
Polyps start off benign. But over time, they can become cancerous. Colorectal cancer screenings can find polyps before that happens. That lets us remove them before cancer develops.
I recommend most people start their screenings at age 45. People at higher risk should start sooner. Typically, I encourage those at higher risk to start at age 40 or 10 years earlier than their parent or sibling who had colorectal cancer or high risk polyp.
You have options
When it’s time for your screening, you’ll have several choices available at Fox Chase Cancer Center. Here’s a breakdown.
Colonoscopy allows a doctor to see the inside of your colon and rectum by means of a flexible tube with a tiny camera and light at the end of it. While you’re sedated, the doctor inserts the tube into your anus, and it continues into your rectum and entire colon. You will not feel anything.
If your doctor finds polyps, they will remove them. Your doctor also will test the polyps to look for signs of cancer. If the results are normal, most people should repeat this test every 10 years—more frequently if your doctor finds polyps.
Virtual colonoscopy is also called computerized tomography (CT) colonography. Because sedation isn’t used, I recommend this option when a patient’s health or other factors make a colonoscopy risky.
During this test, the doctor uses very low doses of radiation to take pictures of your colon from outside of your body. It’s like a CT scan for your colon. You’ll be awake during the screening. If your results are normal, you’ll have the test every five years. If your results are abnormal, you will need to have a follow-up colonoscopy.
Sigmoidoscopy is similar to colonoscopy. During this test, your doctor inserts a shorter (but still flexible tube) with a camera and a light and views the rectum and left colon. The doctor can biopsy (take a sample of) any polyps or tissue they want to look at more closely. However, this test views only the left colon, not the entire colon. You can be either asleep or awake during sigmoidoscopy.
A stool DNA test looks for possible signs of cancer in DNA contained in your stool. The advantage here is that you can do this test yourself at home and mail the stool sample to a testing center. You can do the test every three years. But if your results are abnormal, you’ll need a colonoscopy.
A fecal occult blood test (FOBT) checks your stool for blood, which might be a sign of colorectal polyps or cancer. You can do this test at home, too, but, as I remind my patients, if the results are abnormal, you will need a colonoscopy. There are two kinds of fecal occult blood tests.
With the fecal immunochemical test (FIT), or immunochemical FOBT, you mix a little bit of stool with a solution and either test it at home or mail it to a testing center.
The guaiac FOBT requires you to place a small sample of stool on a card and add a solution to it to look for blood in the stool. You can test your sample at home or in your doctor’s office.
Preparing for colonoscopy
Be sure to follow the preparation instructions to a T. This will ensure that your bowels are completely clean before the procedure. Here are a few prep tips I share with my patients:
Drink the first half of your bowel prep drink as directed. Consume the second half of your drink closer to your appointment time.
Drink slowly.
Keep yourself hydrated by consuming drinks that contain electrolytes. Don’t limit your beverages to tea and coffee.
It’s true that colorectal cancer screening preparation can be uncomfortable. But it’s also true that these tests are very accurate. Polyps can typically be removed during the screening, with no need for a second procedure. And if results are normal, most people won’t need another screening for 10 years. Think of it as an investment in your long-term health.
Expert help when you need it
When you have your colorectal cancer screening at Fox Chase, you can rest assured that experienced experts have verified the results. And if your test reveals any possible problems, we’ll be there to answer your questions and guide you through the best course of treatment, if needed.
We take a multidisciplinary approach to patient care, which means that doctors from our different specialties work as a team to provide the best care for you.
If you are due for colorectal cancer screening, don’t put if off. We offer several types of screening, a comprehensive risk assessment, and follow-up from our multidisciplinary team should any problems arise.
Call Fox Chase at 888-369-2427 to make an appointment, or request one on our website.
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