What are my options?
- Fecal occult blood tests are the most common and inexpensive screening devices. The test involves examining a small portion of the stool to see if any hidden blood, undetectable to the naked eye, is present. This test alone, however, is only 30% effective at detecting early colorectal cancer and therefore needs to be combined with one of the tests below for accurate screening.
Flexible sigmoidoscopy is easy, inexpensive and highly accurate in examining the lower third of the colon. However, since only one-third of the colon is examined, cancers arising in the upper colon may go undetected.
- Virtual colonoscopy is a diagnosis-only test, (as opposed to a conventional colonoscopy which allows both diagnosis and treatment in a single session). The patient must still undergo a preparation and at least 30 percent of patients (in some studies higher percentages) will require conventional colonoscopy to remove polyps 6 mm or larger, which would require a second preparation. It is estimated that at 5 mm, a colon polyp has a 1% chance of harboring colon cancer. A polyp at this size is easily missed with virtual colonoscopy. The risks associated with radiation remain uncertain and this procedure has not yet been endorsed by any multidisciplinary guideline group as an effective colorectal cancer screening strategy. This is also not covered by insurance.
- Colonoscopy is the most reliable method of screening since it visualizes the entire colon and offers the capacity to remove many growths and cancers during the examination. While this is safe, there is a small risk of injury to the colon during the procedure.