A colon cancer screening test can detect polyps and cancers in the colon or rectum. These tests help to identify colon cancers at an early and potentially curable stage. There are several tests used to screen colon cancer. They are grouped into two categories:
These tests are performed either with a scope inserted into the rectum or special imaging (x-ray) tests. They provide a view of the colon structure to find any abnormal areas. If polyps are found during these tests, they can be removed before becoming cancerous. These tests include:
In this test, a doctor examines the rectum and entire colon using a colonoscope, a long, thin, flexible, lighted tube with a small video camera at the end. It is inserted through the anus into the rectum and the colon. Usually, air (or carbon dioxide) is pumped into the colon to expand it so the doctor can observe the colon lining more clearly. The images are viewed on a display monitor. The doctor can find and remove most polyps and some cancers during the test. The test usually takes about 30 minutes. Colonoscopy should be done once every 10 years or more often if recommended by your doctor.
In this procedure, a doctor uses a sigmoidoscope – a flexible, lighted tube with a small video camera at the end to view the rectum and the lower part of the colon. The sigmoidoscope is only 60 centimeters (about 2 feet) long; hence the test can only view the last one third of the colon. It is inserted through the anus into the rectum and the colon. Usually, air (or carbon dioxide) is pumped into the colon to expand it so the doctor can observe the colon lining more clearly. During a sigmoidoscopy, the doctor can detect and possibly remove any abnormal growths. The test should be done once every 5 years or more often if recommended by your doctor.
This test uses special x-ray equipment (a CT scanner) to scan the colon and the rectum and produce a series of images. Before the procedure, air (or carbon dioxide) is pumped into the colon to expand it for better viewing. The images can show polyps and other abnormalities. If polyps or other abnormal growths are found during the procedure, a colonoscopy is usually performed to remove them. The test is performed every 5 years or more often if recommended by your doctor.
Double-contrast barium enema (DCBE):
In this procedure x-rays of the colon and rectum are taken. Liquid containing barium is put into the rectum to outline the inner lining. The x-rays can show abnormal areas in the colon and the rectum. If abnormal growths are seen on the test, a colonoscopy will be performed to further assess or remove them. The test is done once every 5 years or more often if recommended by your doctor.
These tests check for signs of cancer in the stool (feces). They are used when people experience the symptoms of colorectal cancer and other digestive diseases. They are less invasive and can be easily done. They include:
Guaiac-based fecal occult blood test (gFOBT):
This test detects occult (hidden) blood in the stool. Blood in the stool is caused by fragile blood vessels in larger colorectal polyps or cancers that are easily damaged by the passage of feces. The fecal occult blood test (gFOBT) uses a chemical reaction to detect blood in the stool. This test cannot differentiate if the blood is from the colon or from other parts of the digestive tract, such as the stomach. If blood is detected in the stool, a follow-up colonoscopy is recommended. People performing the test receive a test kit to take stool samples at home, with instructions from the doctor’s office. The kit is then returned to the doctor’s office or lab for testing. The fecal occult blood test (gFOBT) test should be performed every year.
Fecal immunochemical test (FIT):
The fecal immunochemical test (FIT) detects occult (hidden) blood in the stool in a different way than the Guaiac-based fecal occult blood test (gFOBT). FIT reacts to part of the human hemoglobin protein(heme), found in red blood cells. It is less likely to react to bleeding from parts of the upper digestive tract, such as the stomach. If blood is detected, a follow-up colonoscopy is done, to determine the source of bleeding. Like the gFOBT, patients use a test kit to collect the stool sample at home. The test is then returned to the lab for testing. FIT is an easy test. The does not require medicinal or dietary restrictions. This test should be done every year.
Stool DNA test:
This is a stool test that looks for specific abnormal DNA or genetic material from cancer or polyp cells. Colon cancer or polyp cells with DNA abnormalities often shed into the stool, where tests may be able to identify them. Cologuard, a stool DNA test also detects blood in the stool. If the test finds DNA changes or blood in the stool, a colonoscopy will be needed. The patient receives a test kit with detailed instructions on how to collect the sample. The sample is then returned to the lab for screening. This test should be done every 3 years.
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