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Bottoms up: “My doctor said I need what?!”

Screening for colorectal cancer: It’s time to stop avoiding the colonoscopy

colonscreen.fwWe’re all prone to the uncomfortable feeling that arises when a doctor mentions screening for colon or rectal cancers. Despite the unease surrounding this topic, it’s time to stop avoiding the colonoscopy and get screened! There are often no symptoms with colorectal cancer. You can’t feel a polyp, and very rarely will you see visible blood. For this reason, screening is the most effective way to be protected.

According to the American Society for Gastrointestinal Endoscopy, colorectal cancer is the third-leading cause of U.S. cancer deaths in both men and women. Further, it is currently the third most commonly diagnosed cancer in the United States. That is why doctors recommend screenings, even though they may be embarrassing to discuss.

Colorectal cancer starts in the colon or rectum, most often as a polyp, or a small piece of tissue that protrudes from the inner wall. Screenings help prevent colorectal cancer by finding precancerous polyps so they can be removed before they progress. Everyone needs screening because we are all at risk for colon cancer. If everyone got screened we could prevent up to 90% of colorectal cancers.

Who should be screened?

  • Starting at age 50, men and women of average risk for colorectal cancer
  • People with a personal or family history of colorectal cancer or pre-cancerous polyps
  • People with inflammatory bowel disease
  • People with certain other risk factors, including a known family history of a hereditary colorectal cancer syndrome

The American Cancer Society recommends the following screening tests:

Colonoscopy (every ten years)

The preferred method for screening, colonoscopy is a procedure to look inside the rectum and colon for polyps, abnormal areas, or cancer. Colonoscopy evaluates the whole colon (large intestine). A colonoscope is inserted through the rectum into the colon. A colonoscope is a thin and flexible, tube-like instrument with a light and a lens for viewing. Through the scope, the doctor can insert tools to remove polyps or obtain tissue samples, which are checked under a microscope for signs of cancer

Flexible Sigmoidoscopy (every five years)

Sigmoidoscopy is a procedure to look inside the rectum and sigmoid (lower) colon for polyps, abnormal areas, or cancer. A sigmoidoscope is inserted through the rectum into the sigmoid colon. Like the colonoscope, the sigmoidoscope is a thin and flexible, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer. Sigmoidoscopy evaluates only the lower third of the colon.

Barium Enema (every five years)

A barium enema is a series of x-rays of the lower gastrointestinal tract. A chalky liquid called barium sulfate is put into the rectum. The barium coats the lower gastrointestinal tract and helps outline the colon and rectum on x-rays. This procedure is also called a lower GI series.

Fecal Occult Blood Test (FOBT) or Fecal Immunochemical Test (FIT) (every year)

A fecal occult blood test and a fecal immunochemical test both check stool (solid waste) for blood that may not be visible. Small samples of stool are placed on special cards or in a small dipstick like devise and returned to the doctor or laboratory for testing. Blood in the stool may be a sign of polyps or cancer.

How often you get screened depends on your risk for colorectal cancer, and on which screening test you use. Some of these tests are done in your home and others must be done in a clinic or hospital.

Take the next step:


Dr. Kim Turgeon

Danielle Kim Turgeon, M.D., is a clinical associate professor in the Department of Internal Medicine at the University of Michigan. Dr. Turgeon received her medical degree from the University of Rochester in New York and her internal medicine residency at Strong Memorial Hospital at the University of Rochester. She also completed a fellowship in gastroenterology at the U-M Medical Center. Her special research interests include colon cancer, chemoprevention, drug metabolism and P450 enzymes. She performs diagnostic and therapeutic endoscopy.

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