Colonoscopy and Colon Cancer Screening Options Tool

The U.S. Preventive Services Task Force (USPSTF) recommends that everyone age 50 to 75 be screened for colorectal or colon cancer. A colonoscopy is the most common, but also the most unpleasant screening test.

Fortunately, there are some alternative screening options available, and we have included a helpful colon cancer screening options tool below to help you choose a screening test that fits your preferences.

Many of our customers are between the ages of 50 and 75, and since we are committed to provide you, our valued customer, with the best possible support, in addition to the natural vitamins and supplements we supply, we are pleased to publish this article and colon cancer screening options tool. We trust you will find it both helpful and informative.

Colon cancer screening saves lives because it can help catch cancer early, when it’s easier to treat.

Screening is important because colon cancer often has no obvious signs or symptoms in its early stages. And, when you start developing symptoms of colon cancer, it’s a sign that the cancer has already been growing and spreading, making it harder to treat.

According to the American Cancer Society, 1 in 21 men and 1 in 23 women in the U.S. will develop colon cancer during their lifetime. It’s the second biggest cause of death from cancer in women, and the third for men.

Colon Cancer Screening Options Tool

No colon cancer screening test, including a colonoscopy, can give you a 100% guarantee that there are no polyps or cancer in your colon or that you won’t develop colon cancer in the interval between tests. No test is perfect and there is no test that’s the best for everyone.

The only question you should be asking yourself is which colon cancer screening test is right for you. And, the best test is the one you actually take.

Use this helpful colorectal or colon cancer screening options tool to help you choose a screening test that fits your preferences.

What Is Colon Cancer?

Colon cancer normally starts as a growth on the inner lining of the colon or rectum. These growths are called polyps. Some of these growths can become cancerous over time (usually many years) but not all polyps become cancer.

Polyps can be benign (harmless), or non-cancerous, or malignant. A malignant growth is cancerous and can spread to other parts of the body.

Colonoscopy and Colon Cancer Screening

Colon Cancer Screening

There are three main colon cancer screening tests.

  1. Colonoscopy
  2. Sigmoidoscopy (Full name is Flexible Sigmoidoscopy)
  3. Stool Tests

Each test has pros and cons.

1) Colonoscopy

Colonoscopy is the most common screening test for colon cancer in the U.S. In fact, it’s called the “gold standard” of colon screening.

There are two types of colonoscopy screening tests.

  1. Colonoscopy
  2. CT Colonography (Virtual Colonoscopy)

1a) Colonoscopy

This is the most common, and preferred, screening test for colon cancer in the U.S. It’s said to be 90% effective in picking up colon cancer.

The three main benefits of a colonoscopy.

  1. Your physician can see your whole colon and rectum so it’s a very thorough procedure.
  2. During the procedure, growths or polyps can be removed and sent for testing to determine whether they are malignant (cancerous).
  3. If no growths or polyps are found, normally you don’t need to have new colonoscopy done for another 10 years.

Colonoscopy Prep

There is no exact prep procedure followed by all physicians but your physician will put you on a colon prep for at least 24 hours before the procedure. This is necessary as the colon and rectum should be empty and clean so your doctor can see the entire lining during the procedure.

You will need to clean out your colon with strong laxatives, designed to clean the colon from the inside by inducing intense diarrhea. You may also be asked to follow a special diet for a day or two before the test, which is normally a bland diet, followed by a liquid diet.

You will more than likely be asked not to eat or drink anything after a certain time the night before your test.

Colonoscopy Procedure

The test takes about 30 minutes but may take longer if polyps are found that have to be removed.

Before the test starts, your physician will normally inject a sedative into a vein to calm you down and make you feel more relaxed and sleepy. It’s common to be awake during the procedure but it’s okay if you fall asleep. 

You will typically be required to lie on your side with your knees pulled up and your physician may insert a finger (wearing a glove) into your rectum to examine it before putting in the colonoscope.

The colonoscope is a long, flexible lighted tube, about the width of a finger, attached to a video camera and monitor. It’s lubricated so it can easily be inserted into the rectum and you should not experience any pain during the procedure. If you’re awake, you may have the urge to have a bowel movement when it’s inserted into your rectum or pushed up to where the colon starts.

Disadvantages of a Colonoscopy

Here are the most common disadvantages of a colonoscopy and the reasons why people are sometimes reluctant to use this colon cancer screening method.

  • The test is invasive and unpleasant

This is probably the main reason why people talk themselves out of going for a colonoscopy, especially if they are feeling fine and have no symptoms of colon cancer.

  • Uncomfortable colonoscopy prep

The 24 hours before the test can be uncomfortable. Drinking large amounts of a liquid laxative solution and having to go to the bathroom often because of diarrhea on the night before the test is not pleasant.

  • Taking a day off work

You would need to take at least one day off work and find someone to drive you home after the test, while you recover from the sedative.

  • It can become very expensive

Not all insurance plans cover the full cost of a colonoscopy. If a polyp is found and removed the test is often reworded from “screening” to “diagnosis” and can become very expensive. Many people simply can’t afford to have a colonoscopy.

Colonoscopy Risks

Colonoscopy is considered by most experts to be a safe colon cancer screening test.

In very rare cases, perforation occurs if the colonoscope punctures the lining of the colon or rectum. This can lead to a very sore belly, as well as nausea and vomiting. Serious complications can develop in the case of infection.

1b) CT Colonography (Virtual Colonoscopy)

CT colonography (also called virtual colonoscopy) is an advanced type of computed tomography (CT) scan where a CT machine takes images of the colon and rectum. A lot of people are not aware of this colon cancer screening test option, and it’s done less often than a conventional colonoscopy. It has good diagnostic accuracy.

The main benefits of a virtual colonoscopy, compared to a conventional colonoscopy.

  1. A virtual colonoscopy is less invasive than a conventional colonoscopy.
  2. With a virtual colonoscopy you don’t need to be sedated.
  3. There is less risk of the colon being injured or punctured than with a conventional colonoscopy.
  4. You normally don’t have to take a full day off work and can drive yourself after the test.

The main disadvantages of a virtual colonoscopy, compared to a conventional colonoscopy.

  1. Needs to be done every 5 years, compared to 10 years for a conventional colonoscopy.
  2. If growths or polyps are detected, a conventional colonoscopy will still be required to remove them or to take a sample tissue for further analysis.

A virtual colonoscopy requires the same type of bowel prep as a conventional colonoscopy.

Virtual Colonoscopy Procedure

The test is done in a special room with a CT machine and takes about 10 minutes to perform.

Although less invasive than a conventional colonoscopy, a small, flexible tube is put inside the rectum to fill the colon and rectum with air. This is required to ensure that the CT machine can get good quality images.

It’s normal to have two scans done, one while you’re lying on your back and one while lying on your stomach or side.

Disadvantages of a Virtual Colonoscopy

As is the case with a conventional colonoscopy, the test is still invasive (though a lot less than with a conventional colonoscopy) and you have to go through the same uncomfortable colonoscopy prep, leading to severe diarrhea.

You may feel bloated and get cramps due to the air in your colon and rectum but this should not last long as the air will normally pass through the body fairly quickly.

2) Sigmoidoscopy

The flexible sigmoidoscopy or just sigmoidoscopy for short is an alternative colon cancer screening test. It’s very similar to a colonoscopy, but there is mainly one key difference, namely:

Unlike a colonoscopy where a colonoscope is used to examine the colon and rectum, a sigmoidoscopy uses a sigmoidoscope to only examine the rectum and sigmoid (the last part of the colon, before the rectum). As such, it’s not as thorough a test as a colonoscopy. The sigmoidoscope is only about 2 feet long, so the doctor can see the entire rectum but only a part of the colon.

The main benefits of a sigmoidoscopy, compared to a colonoscopy.

  1. Bowel prep is normally required, but it’s not as extensive as the bowel prep that is required for a colonoscopy.
  2. You usually don’t have to be sedated during a sigmoidoscopy as is the case with a colonoscopy.
  3. You normally don’t have to take a full day off work and can drive yourself after the test.

The main disadvantages of a sigmoidoscope, compared to a colonoscopy.

  1. Needs to be done every 5 years, compared to 10 years for a conventional colonoscopy.
  2. Only the rectum and a part of the colon are screened, unlike a colonoscopy that screens the rectum and entire colon.
  3. If growths or polyps are detected they may be removed with the sigmoidoscope but a colonoscopy may still be required afterwards to the screen the entire colon for polyps.

Flexible sigmoidoscopy is not widely used for colon cancer screening in the U.S.

Sigmoidoscopy Procedure

A sigmoidoscopy colon cancer screening test normally takes about 10 minutes to 20 minutes to complete, depending on whether growths or polyps are found that have to be removed.

Your physician will normally ask you to lie on your left side on a table with your knees pulled up close to your chest. Your doctor may put a finger (gloved and lubricated) into your rectum first to examine it.

The sigmoidoscope used for a sigmoidoscopy is similar (but shorter) to the colonoscope used for a colonoscopy. And, as is the standard procedure for a colonoscopy, the sigmoidoscope will also be lubricated to make it easier to insert into the rectum.

Air will usually be pumped into the rectum and colon through the sigmoidoscope so your doctor can get a better view of the lining of your rectum and colon.

Disadvantages of a Sigmoidoscopy

The main disadvantage of a sigmoidoscopy (and a colonoscopy we well for that matter) is that the test is invasive and unpleasant. And, as is the case for a colonoscopy, if a polyp is found and removed the test is often reworded from “screening” to “diagnosis” and can become very expensive.

Sigmoidoscopy Risks

It’s possible, however very rare, that the colon or rectum may be punctured during the test, leading to a potentially serious infection.

3) Stool Tests

Home stool tests have become a popular choice for colon cancer screening.

The main benefits of a home stool test, compared to a colonoscopy.

  1. No special diet or bowel prep is required.
  2. No cleansing of the colon is necessary.
  3. No risk of damage to the lining of the colon.
  4. Samples can be collected at home.
  5. No sedation is required.
  6. You don’t have to take day off work.
  7. Non-invasive.
  8. Inexpensive.

The main disadvantages of a stool test, compared to a colonoscopy.

  1. Needs to be done every year, compared to 10 years for a conventional colonoscopy.
  2. If the stool screening test is positive, you will still need a colonoscopy to remove any growths or polyps or find the reason(s) for any bleeding.
  3. Can have false-positive results.
  4. Both the gFOBT test and the FIT test are used to find tiny amounts of blood in the stool but neither test can tell where the blood might be coming from.

There are currently three types of such screening tests that are approved by the Food and Drug Administration (FDA), namely:

  1. Guaiac-based fecal occult blood test (gFOBT)
  2. Fecal immunochemical test (FIT)
  3. Multitarget stool DNA test (MT-sDNA)

Note that the term “occult blood” refers to hidden blood in the stool that are not clearly visible.

Let’s take a closer look at all three.

3a) Guaiac-Based Fecal Occult Blood Test (gFOBT)

This test is used to find tiny amounts of occult (hidden) blood in the stool that could be a sign of cancer or growths (polyps). There are some drug and dietary restrictions for this test as they might affect the results (give false-positive results), such as anti-inflammatory drugs, vitamin C, and red meat. This test may also react to bleeding from other parts of the digestive tract, such as the stomach.

This test is seen by many as outdated but speak to your health care professional and get his or her opinion on whether this screening test may be right for you.

3b) Fecal Immunochemical Test (FIT)

FIT is used as the first line colon cancer screening test in most of the world.

This test is used to find tiny amounts of blood in the stool that could be a sign of cancer or growths (polyps). Unlike gFOBT, there are no drug or dietary restrictions for this test, and this test is also less likely to react to bleeding from other parts of the digestive tract.

It’s generally accepted that FIT has a better detection rate for colon cancer screening than gFOBT.

Studies suggest that the FIT screening test is about 79% accurate in detecting cancer. However, 5% of tests give false-positive results where they suggest cancer while none is present.

This test should be done every year. It only costs about $20 and is covered by Medicare and most health insurance plans.

Some experts suggest that taking a FIT screening test every year equals 10 screenings over 10 years and that this makes this screening test just as good as one colonoscopy every 10 years.

3c) Multitarget stool DNA test (MT-sDNA)

This test detects trace amounts of blood and DNA changes or mutations that may indicate the presence of colon cancer or growths (polyps).

Studies suggest that the DNA screening test (Cologuard is currently the only FDA-approved brand) is about 92% accurate in detecting cancer. However, 14% of tests give false-positive results, which is higher than the FIT screening test.

This test should be done every three years, but yearly testing is preferred. At $649 Cologuard is quite expensive but is covered by Medicare and some private health plans.

Stool Screening Procedure

Your health care provider will give you all the supplies needed for a home stool screening test. This would include a test kit with detailed instructions on how to collect the stool samples. Usually samples from three bowel movements are smeared onto small squares of paper, but different kits may have different instructions.

Once you have collected the samples, return them as instructed in the test kit, usually to your doctor’s office or a lab within two weeks for testing.

 

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