Five Ways to Screen for Colon Cancer

Submitted by Dr. Bruce Waldholtz on April 19, 2021

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Detection requires testing.

Colorectal cancer is one of the most common and deadliest forms of cancer in the United States, but it has one uncommon characteristic—its ability to be detected early. Detection, however, requires testing.  

colonoscopy patientScreening can reduce cancer risk.

Colonoscopy screening can reduce cancer risk and detect it early, when it is most treatable. It is one of the most effective tools available to prevent cancer deaths. In fact, if caught early, colon cancer has a survival rate of nearly 90 percent. And other, effective colon cancer screenings are also available.

The Most Effective Option.

1. Colonoscopy

Colonoscopy is by far the most effective and most popular screening. It is the only colon cancer screening test that can detect and remove precancerous polyps at the same time, potentially eliminating abnormal cells before they become cancerous. During a colonoscopy, your gastroenterologist can see inside the colon and large intestine by using a flexible camera called a colonoscope. It may sound a bit scary, but in the last several years the preparation has gotten easier and most patients report that the test is quick and relatively painless.

Other screenings are options for patients who may be nervous about getting a colonoscopy or have other risk factors. It is important to note that the following screenings can require invasive follow-up with a positive result. You can request more information about colonoscopies here.

Other Screening Options

2. Fecal Immunological Testing

Commonly referred to as FIT testing, this tests for hidden blood in the stool. Using an at-home testing kit, patients provide a small stool sample to the testing lab or physician. This test should be done yearly to reduce colon cancer mortality and is 72 percent sensitive for colon cancer.*

3. Stool DNA testing, including Cologuard®

Cologuard is an at-home test which examines whether there is cancerous DNA in the stool. It is a combination fecal DNA plus a FIT test. A similar stool-based DNA test can also be ordered via your physician. It is 92 percent sensitive at detecting colon cancer and should be done at least every 3 years.* 

*Positive FIT and Cologuard tests must be followed by a colonoscopy.  Both have false positive and false negative rates. 

4. CT colonoscopy (virtual colonoscopy)

This is a type of X-ray that provides physicians with 3- and 4-D pictures of your colon and surrounding areas. These in-depth photos allow polyps and other abnormalities to be detected.

5. Flexible sigmoidoscopy

During a sigmoidoscopy your physician can look at the rectum and part of the colon to spot any abnormality. This type of test does not allow the provider to view the full colon, so it is less widely used than colonoscopy.

Death rates are still increasing in younger age groups.

It is important to note that despite the availability of effective screening, the death rate for colorectal cancer in adults, ages ages 20 to 65, increased one percent each year from 2004 to 2014. The colon cancer death rates for those over age 65 have declined, due to increased screenings in that population.

As a physician, I consider the colonoscopy to be the gold standard test. I recommend this to my family and friends. However, any screening is better than no screening at all. And that’s the truth. Talk to your physician about the screening test that is best for you. Make this brief time commitment to your health for a long-term benefit.

Colon Cancer Screenings in Chesapeake.

Anyone over age 45 should be screened for colorectal cancer every 10 years. Possibly sooner if you have a family or personal history of colon or rectal cancer. For more information about colon cancer, screening and treatment options, visit cancer.org.

Dr. Bruce Waldholtz practices at Gastroenterology Associates and Chesapeake Regional Medical Center.