Which test should I have to screen for colorectal cancer?
- Regular screening can greatly decrease your risk of colorectal cancer.
- Regular screening is recommended for everyone age 50 and older.
- Screening tests find colon polyps. Most cases of colorectal cancer begin as polyps. When polyps are found, they can be removed before they become cancer or while the cancer is in its early stages.
- Colorectal cancer rarely causes symptoms in the beginning. Symptoms such as bleeding from the rectum, a change in bowel habits, and weight loss usually occur later, when the cancer is harder to treat.
- You may need to begin screening at age 40 or earlier and be tested more often if you or members of your family have a history of colon polyps or colorectal cancer.
- You may need to begin screening earlier if you have Crohn's disease or ulcerative colitis.
What is colorectal cancer?
Colorectal cancer is the out-of-control growth of cells in the colon or rectum. These cells grow into masses, or tumors. Most colorectal cancers begin as polyps, which are growths attached to the inside of the colon or rectum. Colon polyps are common, but most of them do not turn into cancer. Polyps are easily found with screening tests and often can be removed during the same procedures.
Colorectal cancer is the third most common cancer in men and women in the United States, and is the second leading cause of cancer deaths.1 It most often strikes people who are older than 50 who have no risk factors in their backgrounds other than their age.
For more information, see the topic Colorectal Cancer.
What are the symptoms of colorectal cancer?
Early-stage colorectal cancer rarely causes symptoms. Symptoms of colorectal cancer usually occur later, when the cancer is are harder to treat. Common symptoms include:
- Pain in the abdomen.
- Blood in your stool or black, tarry stools.
- A change in your bowel habits (such as very narrow stools or frequent diarrhea or constipation).
- Unexplained weight loss.
- Constant fatigue.
Why is regular screening important?
Most colorectal cancer cases can be prevented by having regular screening tests and having polyps removed. Survival rates are higher when colorectal cancer is found and treated early before it spreads to lymph nodes or other organs.
Why is my family's history important?
You are twice as likely to get colorectal cancer if one of your parents, brothers, sisters, or children has had it, especially if that person was diagnosed before the age of 50. There are also two known inherited causes of colorectal cancer: familial adenomatous polyposis (FAP) and hereditary nonpolyposis colon cancer (HNPCC). Most people with these conditions will develop colorectal cancer if they are not treated.
If you have any of these conditions in your background, you will need to be screened at an earlier age-and have more frequent screening-than other people.
For more information, see the topic Colorectal Cancer.
Several tests are available to screen for colorectal cancer:
- Fecal occult blood testing, usually done once a year.
- Barium enema, usually done every 5 years.
- Flexible sigmoidoscopy, usually done every 5 years.
- Colonoscopy, usually done every 10 years.
Flexible sigmoidoscopy (also called a sigmoidoscopy or shortened to "flex sig") and colonoscopy are done in doctor's offices, clinics, and hospitals. A barium enema is done in a hospital or outpatient radiology department.
Complications from barium enema, colonoscopy, or sigmoidoscopy include damage to or puncture of the colon. These complications are rare, but are somewhat more common with colonoscopy than with either barium enema or sigmoidoscopy. Colonoscopy and barium enemas are not recommended for pregnant women, although a colonoscopy can be done if needed.
The decision about choosing a test for colorectal cancer screening takes into account your personal feelings and the medical facts.
Pros and cons of colorectal cancer screening tests
Reasons to have a fecal occult blood test (FOBT) | Reasons not to have a fecal occult blood test (FOBT) |
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Are there other reasons you might want to choose fecal occult blood test? |
Are there other reasons you might not want to choose fecal occult blood test? |
Reasons to have a barium enema | Reasons not to have a barium enema |
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Are there other reasons you might want to choose barium enema? |
Are there other reasons you might not want to choose barium enema? |
Reasons to have a sigmoidoscopy | Reasons not to have a sigmoidoscopy |
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Are there other reasons you might want to choose sigmoidoscopy? |
Are there other reasons you might not want to choose sigmoidoscopy? |
Reasons to have a colonoscopy | Reasons not to have a colonoscopy |
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Are there other reasons you might want to choose colonoscopy? |
Are there other reasons you might not want to choose colonoscopy? |
These personal stories may help you make your decision.
Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about having a screening test for colorectal cancer. Discuss the worksheet with your doctor.
Circle the answer that best applies to you.
I am worried about having discomfort during a colonoscopy, sigmoidoscopy, or barium enema. | Yes | No | Unsure |
I want to have the test that is going to see as much as possible. | Yes | No | Unsure |
I'd rather have one test every 10 years than another test every 5 years. | Yes | No | Unsure |
I prefer a test that I can do by myself at home. | Yes | No | Unsure |
I do not want to miss any work to do this test. | Yes | No | Unsure |
If I have a sigmoidoscopy or barium enema, I will be able to go back to work the same day. | Yes | No | Unsure |
I don't want to have two procedures; I would rather my doctor remove any polyps I might have at the same time that I have a colonoscopy. | Yes | No | Unsure |
I do not have health insurance and cannot afford the cost of the test. | Yes | No | Unsure |
My health insurance won't pay for a colonoscopy but will pay for another type of test. | Yes | No | Unsure |
I am worried about the risk of puncturing or damaging my colon during a colonoscopy. | Yes | No | Unsure |
Use the following space to list any other important concerns you have about this decision.
|
What is your overall impression?
Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason for making your choice.
WebMD Medical Reference from Healthwise
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