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Colorectal cancer screening tests can find growths, called polyps, that can lead to cancer. Doctors recommend that anyone who is at least 50 years old have one of the following screening tests:

Your age, health, and other factors determine which of these tests are appropriate for you.

Air contrast barium enema

Barium is a white substance that allows problem areas of the large intestine to show up on an X-ray. You will be given an enema containing barium before the X-ray. The large intestine appears as a white image, while any growths in the intestine will show up as dark areas.

Colonoscopy

The large intestine (also called the large bowel) consists of the colon and rectum, which is the final part of your digestive system. A colonoscopy checks your entire large intestine for cancer and polyps. It is a very effective test that prevents cancer by painlessly removing any polyps that are found.

In a colonoscopy, a doctor uses a thin, flexible tube to examine the entire large intestine. As the tube is advanced through the intestine, a video sensor in the tube transmits images to a television monitor. Almost all patients are sedated during the procedure, and will need to have someone drive them home. Most patients are at the hospital for about three hours.

Why would a doctor recommend a colonoscopy?

  • To check for polyps, or small growths that may lead to colon cancer. If polyps are found, the doctor can remove them painlessly. This is called a polypectomy.
  • To diagnose inflammatory bowel diseases like Crohn's disease and ulcerative colitis
  • To investigate frequent diarrhea, rectal or intestinal bleeding, a change in bowel habits, or weight loss
  • To take a biopsy of a growth in the large intestine

What does a colonoscopy involve?

You will be given medication to make you relaxed and drowsy (some patients even fall asleep during the procedure). Because air is used to open the colon and create better images, you may feel some minor cramping.

Your doctor will slowly guide the colonoscope through the entire length of the large intestine, which will take about a half-hour. He or she will view the inside of your large intestine on the television monitor, and use a tiny forceps to take a biopsy, or tissue sample, of anything that looks out of the ordinary. This process is painless. In some cases, the doctor may remove a polyp, but you will not feel its removal. The tube is then slowly withdrawn.

How long is the recovery after a colonoscopy?

You will need some time in the recovery room for the effects of the medication to wear off. You will not be alert enough to drive on your own, so make sure a family member or friend can take you home. Plan on resting for the remainder of the day, and eat lightly at first. Minor symptoms such as gas or bloating will disappear within 24 hours.

Learn more about what to expect before, during, and after a colonoscopy

Flexible sigmoidoscopy

Flexible sigmoidoscopy is similar to a colonoscopy, except that it looks only at the lower portion of the large intestine and the rectum, instead of the entire large intestine. Flexible sigmoidoscopy uses a thin, flexible tube to examine the lower portion of the large intestine (the colon) and the rectum. As the endoscopist advances the tube through the lower part of the intestine, a video sensor in the tube transmits images to a television monitor.

The test only takes a few minutes, but as with a colonoscopy, you need to do some preparation beforehand to clean out your large intestine.

Why would a doctor recommend a flexible sigmoidoscopy?

  • Flexible Sigmoidoscopy

    The instrument used for flexible sigmoidoscopy and colonoscopy.

    To check for polyps, or small growths that may lead to colon cancer
  • To diagnose inflammatory bowel diseases like Crohn's disease and ulcerative colitis
  • To investigate frequent diarrhea, rectal or intestinal bleeding, a change in bowel habits, or weight loss
  • To take a biopsy of a growth in the large intestine

What does a flexible sigmoidoscopy involve?

The endoscopist will guide the flexible scope into the lower part of the large intestine, and look at its lining. Because air is used to open the colon and create better images, you may feel like you need to have a bowel movement. If the doctor finds a growth in the intestine, he or she may use a tiny tool to take a biopsy, or tissue sample, to study later. This process is painless. The tube is then withdrawn. The entire procedure takes only a few minutes.

How long is the recovery after a flexible sigmoidoscopy?

You may feel a little cramped and bloated until you pass the air that was introduced into your system. You will be able to resume regular activities immediately.

Hemoccult (fecal occult blood test)

The hemocucult (fecal occult blood test, or FOBT) is a simple test checks for the presence of hidden blood in a patient's stool.

Your doctor may recommend that you have a hemoccult test every year if you are at least fifty years old. This involves sending in a small stool sample, which is checked by a laboratory for hidden blood. The test is simple and quick, but it is not the most accurate method for diagnosing colorectal cancer because the test:

  • Detects any blood found in the stool, including animal blood. For instance, eating a rare steak the day before the test may change the test results
  • Shows if you are bleeding inside your body, but it does not show the source of the bleeding
  • Misses at least 60% of polyps in the large intestine. It also can fail to detect growths that have developed into cancer. This is why doctors often recommend a colonoscopy, or a flexible sigmoidoscopy, to check for polyps and colorectal cancer.
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