Is a Colonoscopy Necessary for Examining Colon Cancer?

Is a Colonoscopy Necessary for Examining Colon Cancer?

Brace yourself, pal, because life ain't all sunshine and rainbows. Some days, you're stuck doing chores like laundry and sifting through emails. And if you're 45 or above, toss a colon cancer screening into the mix - because let's be real, nobody enjoys a colonoscopy prep.

But here's the deal: with the rate of colorectal cancer skyrocketing in those under 55, and more diagnoses coming later-stage, a colon cancer screen is a worthwhile investment, particularly for Alaskan, Native American, and Black individuals who are disproportionately affected.

Just like you can groove to tunes while doing laundry or gamify your inbox, there are ways to spice up colorectal cancer screening. That includes deciding on the test that's perfect for your health risk, budget, comfort, and personal preferences.

What Colon Screening Test Suits You Best?

Here are the seven colorectal screening tests recommended by the U.S. Preventive Service Task Force. These bad boys help detect colon cancer early, as it's the third most common cancer globally.

To find the ideal match, have a heart-to-heart with your doctor about family medical history and current health conditions.

"Equip yourself with that info before chatting with your doc. It can assist them in determining if you are at high risk, needing a colonoscopy, or if other options are feasible. The goal is to pinpoint the best screening strategy for you," advises Dr. Rachel Issaka, a gastroenterologist at UW Medical Center and Fred Hutchinson Cancer Center.

Colonoscopy: The Showstopper

A colonoscopy is the most popular colorectal screening test in the U.S., and it's considered the gold standard. Here's what to expect:

• A prep period: This involves taking laxatives for one or two days to clean your bowels, as well as switching to a liquid diet for approximately a day.
• During the procedure, you'll be under sedation while your doc slides a thin, flexible tube with a camera on the end into your rectum, inspecting your colon for polyps and cancer growths.

Horror stories about the prep? Fear not! Recent changes have made the process more bearable. There are lower-volume and pill laxatives available, avoiding the need to chug gallons of laxative for a clean slate. Pro tips like using wet wipes, drinking laxatives through a straw, and chilling the laxative can also make the process smoother.

Pros of a Colonoscopy: It is the only procedure in which your doctor can locate and remove polyps and cancerous growths during the same treatment. If you have a family history of colon cancer or inflammatory bowel conditions like ulcerative colitis or Crohn's disease, you're at higher risk and should opt for a colonoscopy. Plus, if test results come back clear, you only need the procedure every 10 years (though note those at higher risk may require testing every one to three years).

Cons of a Colonoscopy: The bowel preparation can be rough (thanks to the diarrhea), and the procedure is invasive.

FIT Stool Tests: As Easy as Sample and Send

If you don't have a family history of colorectal cancer or suffer from a bowel condition, you've got additional screening options.

Worldwide, stool tests are the most common way people screen for colon cancer. They work by searching for tiny amounts of blood in your stool. In the U.S., the fecal immunochemical test (FIT) is the stool test used most often, according to Issaka.

Pros of the FIT Stool Test: It's all about ease. There's no prep, laxatives, or liquid diet needed. All you have to do is collect one stool sample and send it off to your doc. "You can do the test at home in the convenience of your own bathroom," Issaka says. "You collect the test at home, and only need to see your doctor if results are abnormal." It's inexpensive (around $25) and covered under the Affordable Care Act.

Cons of the FIT Stool Test: If results are abnormal, you require a colonoscopy to inspect your colon for polyps or cancers. You need to repeat the test annually. Also, there's the high sensitivity gFOBT stool test, which works similarly but is used less frequently and demands dietary restrictions and three stool samples.

Other Non-Invasive Alternatives

While colonoscopies and FIT stool tests are the most common screening tools, other options are available:

• Flexible Sigmoidoscopy: An abridged colonoscopy. You'll need to clean your bowel with an enema instead of laxatives, and your doc will only examine the part of your colon closest to your rectum. It's sometimes done in conjunction with FIT, and if all is clear, you'll take the test every five years.
• Multi-target Stool DNA-FIT tests, such as the Cologuard, measure changes in your DNA that could be early indicators of colon cancer, alongside the FIT test. It is the more expensive stool test (around $600), has a high false positive rate, especially in older adults. Normal results mean you'll test every three years.
• CT colonography, or virtual colonoscopy, involves using a CT scan to look for polyps in your colon. Like a colonoscopy, you must do bowel prep, but you won't be under sedation since your doc isn't inserting anything into your colon. This option is great for those who prefer a non-invasive approach. If results are normal, you only need this test every five years.
• Capsule endoscopy pill camera: Remember the Magic School Bus episode where the bus got swallowed by a student so Ms. Frizzle could explore the human body? Well, the pill camera is like that, but for your colon. You swallow a pill equipped with a camera, and it snaps images of your colon as it travels through your system. It's not a first line defense or commonly used screening test, Issaka says, but it's on the table if you're curious.
• Blood Tests: These are the new kids on the colon cancer screening block. The idea is you get your blood drawn, and it can be screened for colon cancer. Currently, Septin 9 is the available screening test, but more blood tests will soon become available.

Each test comes with its own screening intervals, so choose the one that fits your schedule best.

The Bottom Line: Any Screen is a Good Screen

Still unsure which test to choose? Here's some reassurance: the survival rate of colon cancer when caught early is a staggering 95%, according to Issaka. So, select the best screen that works for you and then book that colonoscopy.

"The ultimate test is the one that gets done and done correctly. Patients shouldn't feel overwhelmed by options. Simply pick one and go for it," advises Issaka.

1. Brace yourself, even amidst laundry and emails, colon cancer screenings are a necessity, especially for those aged 45 and above.
2. With the rates of colorectal cancer growing in younger populations and more late-stage diagnoses, a colon screen can be a wise investment.
3. Much like incorporating music into chores or organizing emails, there are ways to make a colon cancer screening less daunting.
4. When deciding on the ideal colorectal screening test, open a dialogue with your doctor about family medical history and current health conditions.
5. Equipping yourself with this information before discussing your colon screen options can aid your doctor in determining your risk level.
6. A colonoscopy is the most popular colorectal screening test in the U.S., considered the gold standard.
7. For a colonoscopy, a prep period is required, which typically includes taking laxatives and switching to a liquid diet for a couple of days.
8. During the colonoscopy, you'll be under sedation while your doctor examines your colon for polyps and cancer growths using a thin, flexible tube with a camera.
9. Recent improvements have made the colonoscopy preparation process less harsh, with lower-volume and pill laxatives now available.
10. If you have a family history of colon cancer or inflammatory bowel conditions, a colonoscopy is often the best choice.
11. If results from a colonoscopy come back clear, you typically only need the procedure every 10 years, though those at higher risk may require exams more frequently.
12. Another common screening method is the FIT (fecal immunochemical test) stool test, which looks for small amounts of blood in your stool.
13. The FIT stool test is convenient, as no prep or dietary changes are necessary, and it can be done at home.
14. If the FIT test results are abnormal, a colonoscopy is often required.
15. A flexible sigmoidoscopy is an abridged version of a colonoscopy, focusing on the part of your colon closest to the rectum.
16. Multi-target Stool DNA-FIT tests, such as Cologuard, search for changes in your DNA that could be indicative of colon cancer.
17. Cologuard is a more expensive stool test, with a high false positive rate, especially in older adults.
18. CT colonography, or virtual colonoscopy, uses a CT scan to inspect your colon for polyps.
19. Like a colonoscopy, you must clean your bowel with an enema for a CT colonography, but you won't be under sedation.
20. A capsule endoscopy pill camera is a less conventional but available screening option, allowing you to swallow a pill with a camera and view images of your colon as it travels through your body.
21. Blood tests are the newest addition to the colon cancer screening lineup, screening your blood for colon cancer.
22. Septin 9 is the available blood test, but more options will soon become available.
23. Each screening test comes with its own testing intervals, so pick the one most suitable for your schedule.
24. Regardless of the test you choose, the survival rate of colon cancer when caught early is exceptionally high – up to 95%.
25. So, choose the screening test that fits you best and then make an appointment for that colonoscopy.
26. Don't let the options overwhelming; just pick one and take action.

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