How Is Colon Cancer Screening Done?

There are a few different ways to be screened for colon cancer, explains Dr. Mark Gimbel. The standard, more invasive way of screening is through colonoscopy. The less standard, less invasive test is CT colonography, which is a CT scan that allows doctors to see the colon. The downside is that it is high doses of radiation. There are also Barium Enemas which allow photos to be taken of the colon. Watch this video to learn more.

Mark Gimbel, MD:  So screening for colon cancer, there is two ways to go about doing it.  There is the invasive way, which is the standard way of doing the screening versus the noninvasive way, which is a little nonstandard.  The standard treatment or the standard screening tool for colon cancer is at the age of 50 years you get your colonoscopy and a colonoscopy is essentially a long camera that is inserted through the backside goes all the way up and looks the entire colon assessing for any precancerous lesions, which are known as polyps or any cancers as that time.  At the age of 50, when you are supposed to get it, the likelihood of having a sporadic or a normal colon cancer is quite low and that’s why it has been instituted at the age of 50 to go ahead and do that.  There are some other invasive types of screening tools, which you can do as complete as a colonoscopy, one is called a flexible sigmoidoscopy and what that means is the first part of the lower half of the colon as you are coming from the rectum back up is called the sigmoid colon and that’s a higher incidence of having colon cancer than the rest of the colon so we can do a sigmoidoscopy taking a camera and looking at just that part of the colon to assess if there is any premalignant or any polyps that are there or any cancers that are there.  That means to be coupled with a fecal occult blood test, where you test your stool for blood and if you have blood in your stool, there is a higher risk of you having a colon cancer and then you may need to get the full colonoscopy after that.  In terms of the noninvasive tests, there are some newer tests that are coming to light that are being used more frequently.  One of them is called a CT colonography or it is actually a CT scan that has been used as opposed to the camera.  The drawbacks on that it’s a pretty high dose of radiation to get that, but not only does that assess the colon, you can also assess other areas inside the abdominal cavity to see if there is any spread of disease if you do have a colon cancer.  There is also what’s known as a barium enema, which is essentially taking barium which is a type of contrast material through the backside, through the rectum as an enema and then taking pictures of the whole colon and seeing if any defects are seen in the lining of the colon, so if there is a cancer there, you will see a little bump actually on the barium enema in terms of using that as a screening tool.  It’s not completely noninvasive.  It is not having a camera placed up as well.

Dr. Mark Gimbel is a surgical onolcogist at Banner MD Anderson Cancer Center. He graduated from the University of Maryland, interned at the University of Florida – Jacksonville, and completed residencies at Montefiore Medical Center/Albert Einstein College of Medicine in New York.
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