Colorectal cancer screening modalities
The U.S. Preventive Services Task Force (USPSTF) recommends that adults aged 45 to 75 undergo colorectal cancer screening. The decision to screen adults aged 76 to 85 should be individualized. If you are over 75 years of age, consult your doctor regarding screening. Individuals at high risk for colorectal cancer should discuss with their doctor when to begin screening, which test is appropriate for them, and how frequently the test should be performed.
1. Biological mechanism & Early warning signs
Several screening tests can be utilized to detect colorectal polyps or cancer. It is important to note that if your result is positive or abnormal on certain screening tests (stool tests, flexible sigmoidoscopy, and CT colonography), a complete colonoscopy is required to complete the screening process.
2. Diagnostic methods & specialized treatment protocols
STOOL TEST
Fecal occult blood test (FOBT) is performed to detect blood in the stool. This test should be performed annually. You will be provided with 1 kit consisting of 1 vial and 1 stick/brush to collect a stool sample, then return it to the laboratory.
Fecal immunochemical test (FIT) using antibodies to detect blood in stool. This test is also performed once a year similar to FOBT.
FIT-DNA test (also known as stool DNA test) is a combination of FIT with a test that detects altered DNA in the stool. For this test, you collect an entire stool sample from 1 bowel movement and send it to the laboratory, where it is checked for altered DNA and the presence of blood. This test is performed every three years.
FLEXIBLE SIGMOIDOSCOPY
With this method, the doctor will insert a short, thin, lightweight, flexible scope into your rectum to check for polyps or cancer inside the rectum and the lower third of the colon.
Frequency: Once every 5 years or once every 10 years with an annual FIT.
COLONOSCOPY
Similar to sigmoidoscopy, except the doctor will use a longer scope to check for tumors or cancers inside the rectum and the entire colon. During the examination, the doctor can find and remove most polyps and some cancers. Colonoscopy is also used as a follow-up method if any abnormalities are detected in other screening results.
Frequency: Once every 10 years (for people without an increased risk of colorectal cancer).
Computed tomography (CT) colonography utilizes X-rays to reconstruct images of the entire colon, which are subsequently rendered on a computer display for clinical analysis.
Frequency: Once every 5 years.
How do I know which screening test is appropriate for me?
Every screening method has its advantages and disadvantages. Consult your physician regarding the pros, cons, and frequency of each method. The choice of screening modality also depends on:
- Your Request
- Medical Condition
- Personal or family history of colorectal cancer or colorectal polyps, such as familial adenomatous polyposis (FAP) or hereditary colorectal cancer (Lynch syndrome).
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