New Colon Cancer Screening Guidelines

If you’re at high risk, you may need to start screening before 50. That recommendation isn’t new, but it often goes unheeded. Beyond that, the guidelines split colon cancer tests into two groups — tests that lookinside the body and those done on stools. Tests done inside the body can spot cancer and polyps (abnormal growths that may develop into cancer). Stool tests primarily focus on detecting cancer, not polyps, according to the American Cancer Society. Here are the American Cancer Society’s recommendations for both types of tests. Tests for Cancer and Polyps If you’re looking for a test that can spot cancer and polyps, the American Cancer Society recommends choosing between these options: Flexible sigmoidoscopy every five years, or Colonoscopy every 10 years, or Double-contrast barium enema every five years, or “Virtual colonoscopy” (computed tomographic colonography) every five years This is the first time that virtual colonoscopy has made the American Cancer Society’s list of acceptable screening tests. Stool Tests If you’re looking for a stool test, here are the choices recommended by the American Cancer Society. Annual guaiac-based fecal occult blood test (gFOBT) with high test sensitivity for cancer, or Annual fecal immunochemical test (FIT) with high sensitivity for cancer, or Stool DNA (sDNA) test with high sensitivity for cancer (optimal interval between tests unknown) The American Cancer Society notes that stool tests are less likely to prevent cancer than tests that look for cancer inside the body. Also, stool tests must be regularly repeated. And if a stool test finds blood in stools, patients should get a colonoscopy. About the Tests Here is a quick look at the recommended tests: Flexible sigmoidoscopy: Doctors use a thin, flexible tube with a tiny camera to examine the rectum and the lower part of the colon. Colonoscopy: Similar to flexible sigmoidoscopy, but includes the entire colon. Double-contrast barium enema: An X-ray test used to picture the inside of the colon. Virtual colonoscopy: Uses CTscans to picture the inside of the colon.

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Colon cancer screening confusion

False-negative and false-positive results are possible. Flexible sigmoidoscopy Flexible sigmoidoscopy is an exam used to evaluate the lower part of the colon (sigmoid colon). A thin, flexible tube (sigmoidoscope) is inserted into the rectum. A tiny video camera at the tip of the tube allows the doctor to view the inside of the rectum and most of the sigmoid colon. Pros. Sedation isn’t usually needed. Biopsies can be taken through the scope during the exam. The exam typically takes about 15 to 20 minutes. Cons. Typically one or more enemas are done before the procedure to empty the lower part of the colon. In some cases, you might not be able to eat solid food the day before the exam. The exam doesn’t allow the doctor to see the entire colon, so any cancers or polyps farther into the colon can’t be detected. Rare complications may include bleeding from the biopsy site or a tear in the lining of the colon. Cramping or bloating might occur after the exam. Additional tests might be necessary if an abnormality is detected. What’s the bottom line?


Colon Cancer Screenings Work, Twin Studies Report

Colonoscopy, sigmoidoscopy and even fecal blood

Colonoscopy remains the most effective screening tool, reducing the risk of colon cancer death by 56 percent, according to new data published in the Sept. 29 issue of the New England Journal of Medicine. Two other recommended screening methods, however, also greatly reduce colon cancer mortality, the researchers found. Flexible sigmoidoscopy provides a 40 percent lower risk of dying from colon cancer, while annual fecal blood testing offers a 32 percent reduced death risk. “The inclusion of all these tests in the guidelines of major organizations continues to make sense,” said Dr. Durado Brooks, director of prostate and colorectal cancers for the American Cancer Society. “Quite honestly, many patients don’t have access to colonoscopy or are not willing to undergo a screening colonoscopy. Many studies have shown that offering patients options will increase the likelihood that they will complete some form of screening, and that is what is most important.” The results come from a pair of studies testing the long-term health benefits of screening for colon cancer. The first study investigated the use of colonoscopy and flexible sigmoidoscopy among a group of almost 89,000 health professionals during a 20-year period. Colonoscopy uses a thin tube equipped with a camera to examine the entire length of the colon in a procedure for which patients are usually sedated. Flexible sigmoidoscopy is a similar procedure but with a shorter tube that examines less of the colon, so patients do not have to be sedated. The study found colonoscopy was more effective in preventing cancer throughout the entire colon, but that both procedures greatly reduced the overall risk of colon cancer death, said Dr.

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Colon cancer screening: Weighing the options

December 21, 2008 at 18:36 | Report abuse | Reply Jo Ellen Navarro My husband had his first colonoscopy 2 years ago by a gastroenterologist. There were 4 polyps removed and one too large to be removed. He had surgery for that polyp in his rectum which was malignant. The surgeon then scheduled him for a coloscopy (without explaining what it really was to us). He had the surgery and sees an oncologist every 3 months for lab work. They say he is fine and no sign of reoccurence; however, in this time, my brother has died from kidney cancer, our son has died from testacular cancer (metastisezed to the liver) and our best friend has died from colon cancer. Yes, we are always afraid but it has been 2 years now and he is alive, but he is miserable and Hates the colostomy bags. He says he would never go through it again. I recommend the colonoscopy and endoscopy (as I have Barrets) but, PLEASE ask lots of questions…. December 27, 2008 at 16:55 | Report abuse | Reply Gupta Gastro We take colon cancer screening very seriously. The death toll from colorectal cancer is much higher than it needs to be. The rates of death are so high that it is almost equivalent to the American deaths during the Vietnam war YEAR after YEAR. Do your research.

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