Colon Cancer Screenings & Diagnosis

Screening options for colon cancer to detect the condition in its earliest stages.

Colon cancer is among the most common cancers in the United States. It affects more than 130,000 men and women each year. Colon cancer is highly treatable when it is detected early.

Our colon cancer specialists can pinpoint the precise location and stage of a cancer. We offer the most advanced diagnostic tools and screening tests to help us find and treat tumors.

Screening recommendations

Most people should begin regular colon cancer screening at age 50. Patients with a first-degree relative diagnosed with colon cancer should start at age 40, or at 10 years younger than the age the relative was diagnosed.

Colon cancer screening

Sometimes, screening methods other than colonoscopies are the better choice for a patient. We are sensitive to individual preferences and offer the full range of colorectal cancer screening tests. A doctor may order one or more of the following:

  • Sigmoidoscopy or colonoscopy: Physicians may order these exams as follow-up if we find the suspected cancer through a blood test or other screening tests. These give the doctor a clear view of your colon.
  • Fecal occult blood test (FOBT): A lab test that checks stool for early colon cancer.
  • Digital rectal exam (DRE): Your doctor inserts a lubricated, gloved finger to feel for cancer on the rectal wall.
  • Endoscopy: A physician inserts an endoscope (a flexible tube with a camera) through the anus, into the rectum and colon, to view and remove any abnormalities on the colon’s inner lining.
  • Carcinoembryonic antigen (CEA) test: This blood test measures the level of CEA. A higher than normal amount can be a sign of colon cancer or other conditions.
  • Biopsy: A biopsy is a sample of suspicious cells for laboratory examination to confirm if cancer is present.
  • Imaging: Your doctor may order tests to take pictures of the inside of your body. These tests include a CT (computed tomography) scan or X-ray of the colon.

Colonoscopy

A colonoscopy is a reliable exam doctors use to find and remove abnormal tissue growths (polyps) in the colon. Colonoscopy has been proven to save lives with early detection and removal of polyps while they are small, easy to treat, and haven’t spread yet.

Though a colonoscopy is a routine exam, it’s normal to feel anxious. Our team will discuss every step of the procedure with you. After the test, we will discuss the results and any follow-up care with you.

What you need to know about polyps

Polyps are abnormal growths in the colon that may turn into cancer if left untreated. Polyps can:

  • Be large or small. Bigger polyps are more likely to be precancerous, which means they might lead to cancer.
  • Grow directly on the colon, or from a stalk. Polyps with a stalk are less likely to become cancerous.
  • Swell into the colon or rectum.

When doctors find polyps during colonoscopy, they often remove them immediately. This approach can decrease your risk of colon cancer.

Physicians may use one of two techniques to remove polyps. They can:

  • Destroy small polyps using an electrical current, called electrosurgery
  • Use a wire loop to snare and remove larger polyps

Your doctor will send the polyps to a pathology lab for more testing. It can take about a week to receive the results. If your doctor finds polyps during your colonoscopy, you may need further tests for an accurate diagnosis.

What to expect during a colonoscopy

A colonoscopy takes about 30 minutes, but it requires some preparation. A day or two before a colonoscopy, your doctor will ask you to complete a bowel prep. This includes a liquid diet and strong laxatives to empty your colon -- stay near a bathroom as you may need to go frequently.

Here’s what to expect the day of the appointment:

  1. The doctor will give you medicine so you will sleep through the colonoscopy and not feel any discomfort. You will need someone to go with you to the appointment, wait while you have the exam, and drive you home.
  2. In a private room, a colorectal surgeon or gastroenterologist (a doctor who specializes in the intestinal tract and digestive organs) will use a colonoscope -- a thin tube, about the size of a finger, with a light and a tiny camera on the end.
  3. The physician will carefully guide the colonoscope through the rectum and into the colon to view images of the inside of your colon on a screen.

You can go home after the test. You will probably still be sleepy from the medicine, but you can return to your usual activities the next day. Your physician will call you with the results of your colonoscopy.

Understanding your colonoscopy results

Negative results mean the doctor did not find polyps. Your physician will advise you on when you should have another screening. If the doctor finds polyps, the doctor will biopsy the polyps they remove and examine the tissues for cancer under a microscope.

  • Precancerous polyps require regular follow-up colonoscopies. Your doctor might recommend additional procedures or testing right away.
  • Cancerous polyps require more treatment. Your doctor will explain our team’s recommendations to develop a treatment plan.

Open Access Colonoscopy

We offer a service called Open Access Colonoscopy. Patients can schedule routine screening colonoscopies without first going to a gastroenterologist. This saves patients time and money.

You may schedule an Open Access Colonoscopy as long as you are:

  • Between 50 and 80 years old
  • Referred to the endoscopist by the primary care physician

If you have multiple health concerns, a nurse will preview your medical records and consult a doctor first. Some insurance plans do not cover preventive health screenings. Check with your insurance carrier to determine your coverage.

Advanced genetic screening and counseling

Although most people who are diagnosed with colon cancer are older than age 40, some patients are younger. We may recommend genetic counseling for these younger patients and their family members.

If you may be at risk for an inherited cancer, we’ll work with you and our genetics team to recommend next steps. And, we’ll help you and your family members navigate any additional screening or care you may need.

Stages of colon cancer

Part of colon cancer diagnosis is identifying the cancer’s “stage” -- the size of the cancer and whether it has spread. Physicians use ultrasound and MRI (magnetic resonance imaging) to see tumors and stage colon cancer.

Colon cancer is classified as:

  • Stage 0: Physicians identify cancer in the inner lining of the colon (mucosa), but it has not spread deeper into the colon wall. This is also called carcinoma in situ.
  • Stage I: Cancer has spread to the colon wall and possibly into the muscle layer of the colon.
  • Stage II: The tumor has spread deeper into the colon wall. It may extend into the muscle layer of the colon and/or into nearby organs.
  • Stage III: Cancer has spread from the colon. It extends into nearby organs and into or near lymph nodes.
  • Stage IV: Cancer has spread to other parts of the body.

Determining the stage of cancer helps doctors choose the most effective treatment options for you.

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