How should I decide which colorectal cancer screening test to use?
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Dr. Mehmet Oz answered:For a screening test to be effective it should be able to predict with some degree of confidence that a person has cancer long before a sign or symptom appears. In the case of colorectal cancer there are a few types of screening tests that can be used alone or in combination with each other. At this time, many professional organizations view colonoscopy as the gold standard.For a screening test to be effective it should be able to predict with some degree of confidence that a person has cancer long before a sign or symptom appears. In the case of colorectal cancer there are a few types of screening tests that can be... More -
Piedmont Heart Institute answered:Several major organizations, including the United States (U.S) Preventive Services Task Force (a group of experts convened by the U.S. Public Health Service), the American Cancer Society, and professional societies, have developed guidelines for colorectal cancer screening. Although some details of their recommendations vary regarding which screening tests to use and how often to be screened, all of these organizations support screening for colorectal cancer.
People should talk with their health care provider about when to begin screening for colorectal cancer, what tests to have, the benefits and harms of each test, and how often to schedule appointments.
The decision to have a certain test will take into account several factors, including the following:
the person's age, medical history, family history, and general health the accuracy of the test the potential harms of the test the preparation required for the test whether sedation is necessary during the test the follow-up care after the test the convenience of the test the cost of the test and the availability of insurance coverage
This answer is based on source information from National Cancer Institutehas.Several major organizations, including the United States (U.S) Preventive Services Task Force (a group of experts convened by the U.S. Public Health Service), the American Cancer Society, and professional societies, have developed guidelines for... More -
With so many different options to screen for colorectal cancer, it is important to talk to your doctor and discuss which screening method is best for you. Each screening option has appropriate applications and limitations.
Beginning at age 50, men and women at average risk for developing colorectal cancer should begin screening. People with risk factors, such as a family history of polyps, colorectal cancer or other risk factors, should begin screening at an earlier age. Some experts suggest that African-Americans should begin screening at age 45. Patients are advised to discuss their risk factors with their doctor to determine when to begin routine colorectal cancer screening and how often they should be screened. Screening methods include colonoscopy, sigmoidoscopy, stool blood tests such as fecal occult blood test (FOBT) or fecal immunochemical test (FIT), stool DNA, CT colonography (virtual colonoscopy), and barium enema.
Colonoscopy is considered the preferred screening test because it is a preventive exam: it is the only test that both finds and removes precancerous polyps during the same exam. With the other methods, if a polyp is found, that test must then be followed by a colonoscopy to remove the polyp. A person at average risk with normal colonoscopy results won’t need another exam for 10 years. Should a polyp or cancer be found, screening intervals may be more frequent.With so many different options to screen for colorectal cancer, it is important to talk to your doctor and discuss which screening method is best for you. Each screening option has appropriate applications and limitations. Beginning at age... More -
Determining which screening test and when to start screening may depend on individual risk factors. If a first-degree relative has had colon cancer or if you suffer from an illness that affects the bowel that puts you at an increased risk for colon cancer, it may be appropriate to do a colonoscopy, as this will allow the physician to see the entire length of the colon as well as biopsy any suspicious area or lesions. Disadvantages to colonoscopy are that this test requires preparing the bowel beforehand and undergoing sedation for the procedure. There are also some minor risks of bleeding or bowel perforation.
A sigmoidoscopy is another screening tool that visualizes only the descending portion of the colon and rectum and can be performed without sedation. While less invasive than a colonoscopy, a sigmoidoscopy also requires bowel preparation, and there remain some small risks of bleeding or perforations.
Other tests also include imaging such as CT colonography, which is a non-invasive way of visualizing the entire bowel. This test also requires bowel preparation beforehand, and there is no way to biopsy any suspicious areas. Additional screening tests include stool tests that look for blood or abnormal DNA.
If any suspicious results are found on sigmoidoscopy, CT or stool tests, a colonoscopy will likely be scheduled as a follow-up. For a person with average colorectal cancer risks, screening can be done starting at age 50 by either annual stool tests, a sigmoidoscopy or CT colonography every five years, or a colonoscopy every ten years. For higher-risk individuals, it is appropriate to speak with your doctor to determine when to start screening and choosing an appropriate screening test.Determining which screening test and when to start screening may depend on individual risk factors. If a first-degree relative has had colon cancer or if you suffer from an illness that affects the bowel that puts you at an increased risk for colon... More
