Colon cancer can develop without giving symptoms until it is advanced. Following screening recommendations can help prevent polyps from developing into a cancer or at least help detect cancer earlier. Many people avoid screening due to fear, embarrassment, lack of transportation, time or cost. Many times when a person talks with their doctor they may be able to work through some of these barriers and get tested in a way that works for them.
For most people, it is recommended to get screened for colon cancer starting at age 50. If someone is at a higher risk based on personal history inflammatory bowel disease, family history of colon cancer or multiple polyps it may be recommended to start screening much earlier.
The main test I recommend is a colonoscopy. These tests are done by gastroenterologists, colorectal surgeons or general surgeons. Colonoscopies may be done in an outpatient center or in the hospital. It is VERY important to follow the instructions to get ready for this test otherwise the doctor can’t see what they are looking for and things can get missed. For most people the prep is the most unpleasant part of the test since the procedure itself is generally done under sedation and the patient usually doesn’t remember the test. The specific prep varies from doctor to doctor so if you have had this test before and had a problem with the prep – please let the physician know.
Colonoscopies involve using a endoscope with fiberoptics that the doctor inserts in the rectum up into the large intestine to visualize the whole colon. This scope is thin – think the width of my pinky finger.
Colonoscopies may be either done as a screening test or to look for a cause of a symptom – like abdominal pain, rectal bleeding, weight loss, anemia, diarrhea or constipation. If it is done as screening most insurance plans cover this as a preventative benefit. The frequency of testing varies based on risk factors and the reason for the test. If it is a screening test and everything comes back fine – usually the recommendation is to get it redone in 10 years. If there is an abnormal finding during the test, or if the person is at high risk for colon cancer then the test may be repeated in 3 months to 5 years.
Other ways of screening for colon cancer include testing the stool for blood every year, a stool DNA test every 3 years, or a CT colonoscopy, flexible sigmoidoscopy, or a barium enema every 5 years. If these tests come back positive then the next step is to do a colonoscopy. This colonoscopy would then be considered a diagnostic test with your insurance and not a screening test and would most likely not be covered as a screening service. For some people not having to take time off from work to do the test, not having to get a driver to take them to/from the facility, the decreased risk of some alternative tests outweigh the benefit of more definitive and less frequent testing. In any case it is important to note that a digital rectal exam in the doctors office is NOT enough to assess for colon cancer. Please contact me to see what is the best way to do your colon cancer screening.
Below is a YouTube video from CNN that discusses colon cancer screening in more detail.
***Note *** This post, like all my other posts, is for general medical information only and is not to be taken as direct advice. Please consult your personal physician for more information.