Options for Colon Cancer Screening

Few people are excited about the dreaded colonoscopy procedure that is currently recommended every ten years as a screening test for colon cancer. The test itself is not without its major side effects, including perforation of the colon, and the preparation for the procedure is considered brutal for some. Nevertheless, the American College of Gastroenterology is strongly

recommending the test as the Gold Standard for colon cancer screening. Besides screening for colon cancer, it is preventative against colon cancer by removing polyps that can turn into cancer at a later date.

Some doctors want patients to know that there are other, less invasive, ways to check for colon cancer that might be preferable for people who absolutely don’t want to undergo a colonoscopy. One test is called the FIT test, which stands for fecal immunological testing. It tests specifically for human blood in the colon and a person can go onto a more invasive test if the immunological test is positive for human blood. The fecal occult blood test for stool is a more random test that can accidentally become positive if there is animal blood in the stool from eating red meat. The FIT test is clearly better.

Both the FIT test and the FOB test are uninvasive and involve the sampling of stool at the time of a bowel movement. The bit of stool is examined with chemicals for the presence of blood. The test is artificially positive if the person has hemorrhoids that bleed and, in the case of the FOB test, if the individual eats red meat. These tests are easily done at home and should be offered to women and men who refuse the colonoscopy. They are also done in between times when the colonoscopy is recommended. Some doctors do them every year.

A sigmoidoscopy requires a less extensive preparation and looks at the first 60 cm of the colon—the part of the colon that is most likely to have tumors or polyps. It is an inadequate test for those that are at highest risk for colon cancer because these individuals need the whole colon looked at. Still, a flexible sigmoidoscopy is a decent test for many people.

A newer test is not covered for by many insurance companies but that is a good test is the virtual colonoscopy. This involves getting an enema with dye in it and using a CT scan to outline the lining of the colon. It is a test that has about the same sensitivity and specificity of a colonoscopy but without the invasiveness of the colonoscopy procedure. The cost is about $1000 and is good for those who can pay for the test or who have insurance coverage for the procedure.