Q&A: Options for colon cancer screening

iStock_colon-cancer-3×2
The human colon. Colorectal cancer occurs in the colon or rectum when abnormal growths, called polyps, form and become cancerous over time.

Question: Is the fecal smear test my best colorectal-cancer-screening option?

Answer: Being screened for colorectal cancer is crucial. Of cancers that affect both men and women, colorectal cancer (CRC) is the second- leading cancer killer in the United States, according to the Centers for Disease Control and Prevention.

CRC occurs in the colon or rectum when abnormal growths, called polyps, form and become cancerous over time.

Symptoms of CRC can include weight loss, abdominal pain, rectal bleeding, and anemia.

However, the beginning stages of CRC may not show symptoms. Therefore, being screened is the best preventive method.

There are several screening options available, including:

  • Colonoscopy.
  • Fecal immunochemical test (FIT).
  • Flexible sigmoidoscopy with FIT.

The “gold standard” of colon screening is a colonoscopy. Patients prepare for a colonoscopy by drinking special “prep” liquids to clean the bowels. During the procedure, patients are sedated as a flexible colonoscope is inserted into the rectum. A gastroenterologist will look for polyps and other abnormalities. This screening test should be performed every 10 years after the age of 50, according to the American Cancer Society.

FIT is a stool-based test that can be done at your home. A tiny amount of stool is placed into a vial, which you mail to a laboratory for analysis. There is no preparation needed for this test. If lab results show a positive result for abnormalities, the next step is to schedule a colonoscopy. FIT is good for early detection and should be performed every year.

Flexible sigmoidoscopy with FIT is an alternative to both the colonoscopy and FIT tests. Flexible sigmoidoscope does not require a “prep” drink, but the patient does require several enemas to clean out the lower part of the colon. There is also no need for IV sedation, but you can opt to have it. For this test, a flexible tube is placed into the rectum and examines only the lower colon. This is similar to a colonoscopy, but it doesn’t scan the entire colon. If the lab results come back positive, schedule a colonoscopy. This test should be performed every five years along with a FIT test every year.

Each colorectal-screening test has its advantages and disadvantages. Talk to your doctor to decide which test is the right choice for you.

Steven Lichtenstein, D.O., is the chief of the division of gastroenterology at Mercy Health System.

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