Colonoscopy

When to begin screenings

If you have questions about getting screened for colorectal cancer, or if you're concerned about symptoms you are having, contact your health care provider.

• The general recommendation is to begin screening at age 50.
• African-Americans, who have a higher risk for colorectal cancer than other ethnic groups, should begin screening at age 45.
• Anyone with a blood relative who had colorectal, ovarian or uterine cancer has an increased risk for colorectal cancer. Screening should begin 10 years before the age at which his or her family member was diagnosed, or at age 40, whichever comes first. If you have questions or concerns about the genetics (hereditary factors) of colorectal cancer, you may want to talk with a genetics counselor.
• If you have other risk factors, such as inflammatory bowel diseases, Crohn's disease or ulcerative colitis, or a history of colorectal polyps, talk with your health care provider about when to get screened.
• Colorectal cancer often has no symptoms. But any unusual bowel or abdominal symptoms should be evaluated by your health care provider, and screening might be recommended. 

Screening options

Talk with your health care provider about the best choice for you:

• Colonoscopy – A colonoscope, a long, slender, flexible tube with a lighted end,  is inserted into the colon through the rectum. This allows the physician to look at the entire colon and to snip polyps or tissue for biopsies if anything looks suspicious. Colonoscopy is the most accurate and complete of the screening test options, and is performed with the patient under mild sedation. 
• Stool blood test – A sample of stool, often gathered with a "fecal occult blood testing" kit, is tested for any traces of blood.
• Flexible sigmoidoscopy – A sigmoidoscope,  a slender, flexible tube with a lighted end,  is inserted into the colon through the rectum. It allows the physician to look for blood and/or polyps in the lower portion of the colon. Polyps or suspicious tissue can be snipped for biopsy.
• Double contrast barium enema – A chalky liquid and air are pumped into the colon through the rectum, which makes the colon expand and allows clear X-rays to be taken.
• CT colonography (computed tomographic colonography, also know as "virtual" colonoscopy)  – Air is pumped into the colon through the rectum and a special CT scan of the expanded colon is taken. This is a new test, still under study for its effectiveness.

Recommended screening schedule

If you have significant risk factors for colorectal cancer, ask your health care provider for a recommended screening schedule.

If you don't have significant risk factors, your health care provider may recommend one of the following:

• Colonoscopy every 10 years
• Yearly stool blood test
• Flexible sigmoidoscopy every five years
• Yearly stool blood test plus a flexible sigmoidoscopy every five years
• Double contrast barium enema every five years

If polyps are found

Polyps found during colonoscopy or sigmoidoscopy can usually be removed and sent for laboratory analysis to determine their type. Your recommended schedule of screenings will depend on the type, number and size of the polyps, your family history and any other risk factors.

If your screening does find cancer, please feel free to call our Oncology Nurse Navigators at 1-877-777-0112. They can answer your questions, help you find a cancer specialist, and guide you through your treatment.