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What is the best option for colon cancer detection?

   January 4, 2024
What is the best option for colon cancer detection?


What is the best option for colon cancer screening and when should it be done?

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States and the incidence rate is increasing. particularly among adults ages 20 to 49. Unfortunately, only about 30% of eligible adults in the United States have been screened for CRC.

Screening tests that look for cancer or precancerous growths called colon polyps can help prevent colon cancer.

When is the best time to start screening?

Patients at average risk do not have a personal or family history of colon cancer, nor do they have a genetic disease that increases their risk of getting CRC. As a result, patients should discuss their family history with their primary care physician, including all cancer diagnoses in blood relatives, so that the optimal time to begin colon cancer screening can be determined.

What type of exam should I take?

The most crucial aspect of colon cancer screening is performing a test. Colonoscopy or the FIT test are the most popular procedures to screen for colon cancer in most patients. If you can’t or don’t want to have a colonoscopy or FIT test, there are other options to think about. Finally, this is a personal and essential decision that the patient must address with their healthcare professional so that the appropriate test can be performed at the right time.

It is recommended that high-risk people be screened before age 45. A primary care doctor can help identify when and how a patient should be screened for CRC if you are concerned about their risk level. Patients with a history of CRC or polyps, a first-degree relative with CRC or advanced polyps (those that would have progressed to CRC if not removed), a family history of certain genetic syndromes, or a history of inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis) are high risk factors.

What screening options are available for CRC?

Colonoscopy: Colonoscopy is the gold standard of screening and detects approximately 95% of CRC cases. It is also the only way for a gastroenterologist to discover and remove potentially malignant colon polyps at the same time. Although colonoscopies are generally low-risk procedures, they may include a lower risk of bleeding and perforationwhich increases with age.

Before the operation, patients must drink a colonoscopy preparation, which removes stool from the colon so that it can be properly examined during the procedure. Prescribing instructions for the preparation are provided by the gastroenterologist’s office.

To ensure that the patient is as comfortable as possible, the procedure is usually performed under anesthesia. It is vital to note that patients do not receive general anesthesia, but generally feel tired and relaxed throughout the procedure.

A gastroenterologist will place a colonoscopy, a flexible tube with a camera on the end, into the rectum during a colonoscopy. The colon is then carefully examined. If no polyps are found and the colon has been adequately prepared (cleansed), it is recommended to repeat the colonoscopy in 10 years. This period will be shorter if polyps are discovered or if the patient’s risk level or symptoms change.

The fecal immunochemical test (FIT) It is a laboratory test that looks for blood in the stool. Patients collect their stool with a kit and then scrape it with a probe, which is then placed in a tube and mailed to the laboratory. FIT tests are performed every year. A disadvantage of the FIT test is that it has a false positive rate of approximately 5%. With an accuracy rate of 79 percent, can effectively rule out CRC. For many people, the FIT test is a viable alternative to colonoscopy because it is non-invasive, convenient, and cost-effective. If a stool test gives a positive result, a colonoscopy is required to determine the cause of the positive result.
Flexible sigmoidoscopy: The rectum and lower part of the colon are examined using a flexible tube with a camera. This treatment has the advantage of being faster than a colonoscopy (only 5 to 15 minutes) and requiring less aggressive laxative medications. If no polyps are found, individuals typically undergo flexible sigmoidoscopy every five years. Because this test does not scan the entire colon, it cannot detect malignancies or polyps in areas that have not been investigated. It can detect 70 percent of tumors and polyps. probably. If an abnormality is discovered, a second colonoscopy will be necessary to examine the entire colon.
CT colonography: A CT scan is used to view the rectum and entire colon. Patients should take laxatives the night before a colonoscopy, just as they would for a colonoscopy. To achieve clear photographs, a small tube is inserted into the rectum to stretch the colon. Patients who cannot tolerate anesthesia or who have other medical problems that prevent them from undergoing a colonoscopy may benefit from this test. Radiation exposure and the discovery of unrelated abnormalities beyond the colon, which could lead to unnecessary investigations, are two disadvantages of CT colonography. While CT colonography is 86.7 percent accurate in detecting specific polyps, It is less reliable overall than colonoscopy.. If the CT colonography result is abnormal, a colonoscopy is required to evaluate the entire colon.
Cologuardia is a test that requires patients to collect their stool, scrape it with a probe, place it in a container filled with preservative, and mail it to the laboratory. This test looks for unusual DNA or traces of blood in the stool, which could indicate precancerous polyps or CRC. Patients usually repeat the exam every three years. A colonoscopy is required for further evaluation if the Cologuard test is positive. However, Cologuard’s accuracy is still restricted; 13% of the time, the test suggests the patient has cancer when they do not. Annual FIT testing or colonoscopy may be more effective and less expensive than Cologuard, according to a study published in 2019. More studies are being done to determine how reliable (and beneficial) this test is for detecting CRC.

What type of exam should I take?

The most crucial aspect of colon cancer screening is performing a test. Colonoscopy or the FIT test are the most popular procedures to screen for colon cancer in most patients. If you can’t or don’t want to have a colonoscopy or FIT test, there are other options to think about. Finally, this is a personal and essential decision that the patient must address with their healthcare professional so that the appropriate test can be performed at the right time.

For people at average risk, the U.S. Preventive Services Task Force recommends starting CRC screening at age 45.

Photo by Anna Tarazevich from Pexels



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