Screenings for Colorectal Cancer
Screenings are the best way to prevent and detect colorectal cancer. If colorectal cancer is found and treated early, the 5-year survival rate is about 90%. Screening can catch the disease while in its earliest stages, potentially finding polyps before they become cancerous or finding cancer before it has spread beyond the colon or rectum. If abnormalities are detected early, diagnosis and treatment can occur sooner, when the cancer is most treatable.
To schedule a screening, please call our access line at 877-313-0503.
Because age is the most common risk factor for colorectal cancer, everyone over age 50 should get screened. Patients with a personal or family history of colorectal cancer should talk to their doctors about getting screened before age 50. Most people should be screened every 7 to 10 years; however, those with additional risk factors should be screened every 5 years.
Many insurance plans and Medicare help pay for most colorectal cancer screening tests. Many insurance companies do not cover virtual colonoscopies, so check with your insurance provider to find out which tests are covered for you. To find out about Medicare coverage, call 1-800-MEDICARE (1-800-633-4227) or visit www.medicare.gov.
A colonoscopy is considered the primary and most effective technique to screen patients age 50 to 75 for colorectal cancer. If you are older than 75, ask your doctor about screening.
A colonoscopy is a safe, private and usually painless procedure that takes about 30 minutes to complete. During the procedure a digestive health specialist uses a colonoscope to see the entire colon. If a polyp is found, the doctor may remove it.
If anything else looks abnormal, a biopsy may be performed at the same time. During the procedure, a physician takes a small piece of tissue out through the colonoscope. The tissue is sent to the lab to see if cancer cells are present. A colonoscopy may be done in a hospital outpatient department, in a clinic, or in a doctor's office.
For a colonoscopy to be effective the colon and rectum must be be empty and clean.
The day before the test, you will take medication to clean out your colon and may be prescribed an enema for the morning of the procedure. Your doctor will give you instructions to help you prepare for your colonoscopy. Read the instructions carefully a few days before your colonoscopy, since you may need to shop for special supplies and get laxatives from your pharmacist. If you have any questions, call your doctor's office to review step-by-step instructions.
Many patients find the bowel preparation to be the most unpleasant part of the test, as you will experience several loose bowel movements, and will spend quite a bit of time in the bathroom. You may be given other instructions, too, such as foods to avoid before the test.
Be sure your doctor is aware of any medications you are taking, as you may need to change how you take them before the test.
The colonoscopy itself usually takes about 30 minutes, but it may take longer if a polyp is found and removed. Before the test begins, you will be given medication through an IV to make you feel comfortable and sleepy. You may be awake, but you will not be aware of what is going on and may not remember the test afterward. Most people will be fully awake by the time they get home from the test.
If a small polyp is found, the doctor may remove it. If your doctor sees a larger polyp or tumor or anything else of concdern, a biopsy may be performed at the same time. During a biopsy, your doctor takes a small piece of tissue out through the colonoscope. The tissue is looked at under a microscope to see whether it is a cancerous growth, a benign (non-cancerous) growth or a result of inflammation.
You should plan to have someone drive you home, as the medication used can affect your ability to drive. Some people may experience pains or cramping after the test, but most feel fine once the sedation and laxatives wear off completely.
Flexible sigmoidoscopy:
A sigmoidoscope is a thin, flexible, lighted tube about the thickness of a finger. It is placed into the lower part of the colon through the rectum. This allows the doctor to look at the inside of the rectum and part of the colon for cancer or polyps. Because the tube is only about two feet long, the doctor is only able to see about half of the colon. The test can be uncomfortable, but it should not be painful. Be sure your doctor is aware of any medications you are taking, as you may need to change how you take them before the test.
Before the test, you will need to take medication to clean out your colon and rectum. This is so the doctor can clearly see the lining of the intestine. If a small polyp is found your doctor may remove it during this test. This can be done with tools used through the scope. If a polyp or colorectal cancer is found during the test, you will need to have a colonoscopy to look for polyps or cancer in the rest of the colon.
A sigmoidoscopy usually takes 10 to 20 minutes. Most people do not need to be sedated for this test, but this may be an option you can discuss with your doctor. If you are sedated, you will need some time to recover, as well as someone with you to take you home after the test.
Virtual colonoscopy:
Virtual colonoscopy (also called CT colonography) involves using special computer programs to create both two-dimensional X-ray pictures and a three-dimensional "fly-through" view of the inside of the colon and rectum, which allows the doctor to look for polyps or cancer. The CT scanner takes many pictures as it rotates around you while you lie on a table. A computer then combines these pictures into images of the colon and rectum.
This test may be useful for some people who cannot have or do not want to have tests where a tube or scope is inserted into the colon or rectum. It can be done fairly quickly and no sedation is necessary. But patients still need to do the same type of bowel preparation. If polyps or other problems are seen on this test, a follow-up colonoscopy will likely be needed to remove them or to get a better look at them.
The cost of virtual colonoscopy is not generally covered by insurance plans but patients should check with their individual plans to be sure.
Fecal occult blood test:
The fecal occult blood test is a test for blood in a sample of stool (feces) that has already passed. Blood in your feces may be the result of bleeding from a cancerous polyp in the colon or rectum or it may be a symptom of a benign condition. Checking for hidden (occult) blood in the stool can be done at home. You can buy a test kit at a pharmacy without a prescription, or your doctor can provide or order a test kit for you to use at home. If a home fecal occult blood test finds blood in your stool, call your doctor.
Double-contrast barium enema (DCBE):
A double-contrast barium enema involves the injection of a fluid called barium followed by air into the rectum. This makes the entire colon visible on an X-ray and allows doctors to see abnormal growths, like polyps. If your doctor sees something suspicious during a DCBE, he or she may order a follow-up colon cancer screening test such as a colonoscopy or flexible sigmoidoscopy.
You prepare for a DCBE the same way you would prepare for a colonoscopy, taking laxatives the day before your test that ensure that your colon and rectum are empty and clean for the procedure.
The test takes about 30 to 45 minutes. You will lie on a table and your doctor will use a small tube inserted into your rectum to partially fill your colon with barium sulfate. Barium sulfate is a white, chalky liquid that helps the doctor see the outline of your colon on an X-ray. After the barium is placed into your colon, your doctor will add air to improve the view on the X-ray and help detect abnormal growths.
Your doctor will take X-rays from several different angles to see your whole colon. Your doctor may ask you to move around on the table and turn over to help spread the barium sulfate through your colon and provide additional views.
You will not be sedated for the DCBE test. If you are worried about this, talk to your doctor about other tests that may work better for you and during which you can be sedated.
