CityView Magazine

considers colonoscopy the “gold standard” for colorectal screening because it allows physicians to look directly at the entire colon and to identify precancerous growths known as polyps. Detection or screening tests for colon cancer include DNA tests of stool for gene mutations, stool tests for blood or breakdown products of hemoglobin, or computed tomography scanning (CT colonography) however these tests do not allow for the removal of precancerous polyps. Colonoscopy or flexible sigmoidoscopy (which evaluates the distal part of the colon) are the only tests that allow for biopsy or removal of polyps at the time of their discovery. Over the past two decades increases in the number of people being screened for colon cancer has been associated with a decrease in death due to colon cancer. What are Screening Options? Talk to your doctor about which screening tests are right for you. Colonoscopy – For normal risk individuals the American College of Gastroenterology recommends colonoscopy screening every 10 years starting at age 50. African Americans may develop colorectal cancer at a younger age compared with other ethnic groups. For this group of patients colorectal cancer screening has been recommended starting at age 45. Flexible Sigmoidoscopy and Fecal Occult Blood Test – An alternative strategy for average risk individuals is an annual stool test for blood and a flexible sigmoidoscopy every 5 years. This test has lost favor due to the fact it is performed unsedated, its inability to evaluate the first 2-3 feet of the colon and the widespread acceptance of colonoscopy. Virtual Colonoscopy Virtual colonoscopy involves the ingestion of contrast followed by CAT scanning of the entire colon. This test does not require sedation and may detect abnormalities outside of the colon, i.e., liver, kidneys, pancreas etc. Virtual colonoscopy is not as sensitive as a colonoscopy in that it may miss small lesions and there is significant radiation exposure. It still requires taking a purgative to cleanse the colon and if a lesion is seen the patient will still need colonoscopy to remove the lesion Fecal DNA or occult blood testing for colon cancer Stool tests are categorized as cancer detection tests, not cancer prevention tests. Stool samples are placed on a card and developed to detect the presence of blood, hemoglobin byproducts or genetic abnormalities common in the abnormal growth of polyps or cancer. This test can be performed at home and doesn’t require a purgative. However it may only detect 40- 80% of polyps or cancers. In summary, colon cancer is one of the most preventable forms of cancer but unfortunately only 30-40% of patients eligible for colon cancer screening are actually being screened. Talk to your doctor today about which screening test is most appropriate. Remember an ounce of prevention is worth a pound of cure.CV 66 | May/June • 2011

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