Only about 70 percent of Americans between the ages of 45 and 75 are up to date with their colon cancer screenings. This number could improve if people would discuss the various available colon cancer screening tests with their healthcare providers and then choose the tests right for them.
Let’s learn more about these tests, including the pros and cons of each and the guidelines on how to choose.
Two General Types of Colon Cancer Screening Tests
Gastroenterologists offer two general categories of colon cancer screening tests: stool-based and visual examinations.
Stool-based tests lab-analyze a person’s feces to detect the presence of blood. Blood in the stool can, but not always, indicate benign colon growths called polyps or the presence of malignant tumors. While polyps or adenomas are not cancerous, all cancer begins in polyps.
Visual examinations are the sigmoidoscopy and colonoscopy. Sigmoidoscopy inspects the lower colon and rectum, while colonoscopy, the most complete and accurate visual examination, reveals the interior of the entire length of the large bowel.
Both tests utilize lighted endoscopes equipped with lights and tiny cameras that take videos and still images. Through the scopes, doctors can remove tissue for biopsy and even cauterize areas of bleeding caused by various lower GI conditions, such as diverticulosis.
Today’s most accurate test is the colonoscopy. Favored by digestive health specialists, PCPs, and other healthcare providers, this outpatient procedure removes polyps completely so they can be biopsied. The test takes only about 30 minutes, is painless, and requires only mild sedation to keep patients comfortable. The test does require colon cleansing the day before and the day of the procedure with fasting, clear liquids, and laxatives to ensure all fecal material is evacuated from the bowel. Most people screened with colonoscopy repeat the tests every 10 years–sooner if polyps are detected and removed.
The close “cousin” of the colonoscopy is the sigmoidoscopy. Similar in preparation, this visual inspection helps the doctor see the rectum and lower portion of the large bowel. It does not allow views or images of the entire colon. That being said, this painless examination only takes about 10 minutes and requires no sedation whatsoever. Patients may drive themselves to and from their tests and receive biopsy results within a few days, as with colonoscopy.
Another option for colon cancer screening is the fecal occult blood test, or FOBT, which reveals the presence of blood in stool samples. The test is done at home: the patient provides a stool sample and sends it to a medical lab for analysis.
There is no special preparation before this type of screening–in other words, no fasting, no laxatives, and no sedation. Blood may indicate polyps or even cancerous tumors; however, bleeding can come from other GI conditions, too. As such, gastroenterologists always follow up the positive FOBT with a full colonoscopy examination.
The fecal immunochemical test is very similar to the FOBT. A positive test also requires follow-up with a colonoscopy. With either fecal smear test, positive results can indicate bleeding from stomach ulcers, hemorrhoids, or even dietary choices, such as rare steaks.
Which Colon Cancer Screening Test Is Appropriate for Me?
This question is best answered in consultation with your primary care physician or gastroenterologist. Both providers are likely to prefer colonoscopy if you are a person of average cancer risk between the ages of 45 and 75. People with a family history of colon cancer–particularly those diagnosed earlier than age 45 should begin routine colonoscopy sooner.
While many people are reluctant to have a colonoscopy because of the bowel preparation and sedation, it is the most accurate and complete assessment. If you do not respond well to sedation or are medically too frail to do the preparation and fasting regimen, stool tests may be the better option. Be aware, however, that stool-based tests can give false positives and that any positive stool-based test requires a colonoscopy afterward.
Colon Cancer Screening in Westlake and Brooklyn, Ohio
Whatever method you and your doctor determine is right for you, colon cancer screening can save your life. North Shore Gastroenterology is your colon cancer screening provider in Westlake and Brooklyn. Our gastroenterologists have the specialized training to perform sigmoidoscopy and colonoscopy, minimizing the risk of complications for the patient.