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Colon and Rectal Cancer Screening
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  • Colon and rectal cancer screening is a technique in which doctors check the colon and rectum for signs of cancer or growths (called polyps) that may become cancer. It is done in people who have no symptoms and no cause to believe they have cancer. The goal is to find and remove polyps before they become cancer, or to find cancer early, before it grows, spreads, or causes problems.

    The colon and rectum are the end part of the digestive tract. When doctors speak about colon and rectal cancer screening, they use the term “colorectal.” That is just a shorter way of saying “colon and rectal.” It’s also possible to say just colon cancer screening.

  • They contain:

    • Colonoscopy– Colonoscopy allows the doctor to see directly inside the complete colon. Before you can have a colonoscopy, you must clean out your colon. You do this at home by drinking a special liquid that causes watery diarrhoea for several hours. On the day of the test, you get medicine to help you relax. Then a doctor puts a thin tube into your anus and advances it into your colon. The tube has a tiny camera attached to it, so the doctor can see inside your colon. The tube also has tiny tools on the end, so the doctor can remove pieces of tissue or polyps if they are there. After polyps or pieces of tissue are removed, they are sent to a lab to be checked for cancer.
    • CT colonography(also known as virtual colonoscopy or CTC) – CTC looks for cancer and polyps using a special X-ray called a “CT scan.” For most CTC tests, the preparation is the same as it is for colonoscopy.

     

    • Stool test for blood– “Stool” is another word for bowel movements. Stool tests most commonly check for blood in samples of stool. Cancers and polyps can bleed, and if they bleed around the time you do the stool test, then blood will show up on the test. The test can find even small amounts of blood that you can’t see in your stool. Other less serious situations can also cause small amounts of blood in the stool, and that will show up in this test. You will have to collect small samples from your bowel movements, which you will put in a special container you get from your doctor.
    • Sigmoidoscopy– A sigmoidoscopy is similar in some ways to a colonoscopy. The difference is that this test looks only at the last part of the colon, and a colonoscopy looks at the whole colon. Before you have a sigmoidoscopy, you must clean out the lower part of your colon using an enema. This bowel cleaning is not as thorough or unpleasant as the one for colonoscopy. For this test, you are not required to take medicines to help you relax, so you can drive and work afterward if you want.
    • Stool DNA test– The stool DNA test checks for genetic markers of cancer, as well as for signs of blood. For this test, you get a particular kit in order to collect a whole bowel movement. Then you follow the advice about how and where to ship it.
    • There is no blood test that most experts think is accurate enough to use for screening.

Work with your doctor to decide which test is best for you. Some doctors might choose to combine screening tests, for example, sigmoidoscopy plus stool testing for blood. Being screened–no matter how–is more important than which test you choose.

Doctors suggest that most people begin having colon cancer screening at age 50. People who have an increased risk of getting colon cancer sometimes begin screening at a younger age. That may include people with a strong family history of colon cancer, and people with diseases of the colon called “Crohn’s disease” and “ulcerative colitis.”

Most people can stop being screened around the age of 75, or at the latest 85.

That depends on your risk of colon cancer and which test you have. People who have a high risk of colon cancer often need to be tested more often and should have a colonoscopy.

Most people are not at high risk, so they can decide one of these schedules:

  • Colonoscopy every 10 years
  • CT colonography (CTC) every 5 years
  • Stool testing for blood once a year
  • Sigmoidoscopy every 5 to 10 years
  • Stool DNA testing every 3 years (but doctors are not yet sure of the best time frame for repeating the test)
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Colorectal Cancer Screening

Could you be at risk?

Could you be at risk?

You are here >> Home > Blog > Large Bowel > Cancer >Colorectal Cancer Screening

Colorectal cancer often develops from polyps in the colon or rectum, and screening plays a crucial role in detecting these early changes. Screening helps find cancer or pre-cancerous polyps before symptoms appear, improving the chances of successful treatment. Early detection through screening can prevent the development of cancer and make treatment less invasive.
 
With rising cases in India due to changing lifestyles, regular screening, especially for those over 45, is essential for early diagnosis and prevention. In this blog, we’ll explore the key facts about colorectal cancer screening, who should get tested, and the different screening methods available.
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What is Screening?

How Does Screening Help in Early Detection?

⦿ Screening helps find colorectal cancer at an early stage when it hasn’t spread.

⦿ Tests like colonoscopy can also remove polyps before they turn cancerous.

⦿ Early detection through screening leads to better treatment options and survival rates.

Common Cancers Where Screening is Essential

⦿ Screening is important for breast, cervical, lung, and colorectal cancers.

⦿ For colorectal cancer, screening is especially crucial because it can prevent cancer by removing polyps.

⦿ Regular screening is recommended for people over the age of 45 and those at higher risk due to family history.

Colorectal Cancer Screening

Why Screening is Important?

Early Detection Improves Treatment Outcomes

⦿ Early detection allows for less invasive treatment options.

⦿ When cancer is found early, surgery and treatment are more effective, and recovery is quicker.

⦿ Late-stage colorectal cancer often requires more aggressive treatments and has lower survival rates.

Screening Can Prevent Cancer by Detecting Polyps

⦿ Polyps are small, non-cancerous growths that can develop into cancer over time.

⦿ Screening tests like colonoscopy can detect and remove these polyps before they become cancerous.

⦿ By removing polyps, screening helps prevent colorectal cancer from developing.

Increased Survival Rates With Early Diagnosis

⦿ More than 90% of patients diagnosed with early-stage colorectal cancer can be successfully treated.

⦿ As cancer advances, survival rates drop significantly, making early detection critical.

⦿ Regular screening increases the chances of diagnosing cancer at a stage where treatment is more effective.

Who Should Get Screened?

People Above 45 Years of Age

⦿ Most guidelines recommend that people start getting screened for colorectal cancer at the age of 45.

⦿ This is because the risk of developing colorectal cancer increases with age, and screening helps detect it early when it’s most treatable.

Individuals With a Family History of Colorectal Cancer

⦿ If someone in your immediate family (such as a parent or sibling) has had colorectal cancer, your risk is higher.

⦿ You may need to start screening earlier than age 45 and be screened more frequently.

⦿ Genetic factors can increase your likelihood of developing colorectal cancer.

Those With Certain Risk Factors

⦿ Lifestyle factors like obesity, smoking, and a diet low in fiber can increase the risk of colorectal cancer.

⦿ People who follow a diet high in processed and red meat, and low in fruits and vegetables, are at higher risk.

⦿ Smoking and lack of exercise further contribute to the development of colorectal cancer.

High-Risk Groups

⦿ People with conditions like inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis, are at higher risk.

⦿ If you have a family history of polyps (growths in the colon or rectum), your doctor may recommend early and frequent screening.

⦿ Genetic conditions like Lynch syndrome can also increase colorectal cancer risk, requiring more proactive screening.

Colorectal cancer screening is crucial for individuals with specific risk factors, such as age, family history, and lifestyle choices. The table below summarizes different risk groups, the reasons they should get screened, and the recommended age to start screening:
Risk Group Reason for Screening Recommended Screening Age Frequency
People above 45 years of age Age increases risk of colorectal cancer Age 45 Every 10 years (Colonoscopy)
Family history of colorectal cancer Genetic predisposition to colorectal cancer Earlier than 45 (based on doctor’s advice) Depends on risk level, typically every 5 years
Individuals with obesity, smoking, or low-fiber diet Lifestyle factors that increase cancer risk Age 45 Every 10 years (Colonoscopy)
High-risk groups (IBD, family history of polyps) Higher likelihood of developing colorectal cancer Earlier than 45 (based on doctor’s advice) More frequent, possibly every 1-3 years

Types of Screening Tests

Fecal Occult Blood Test (FOBT)

⦿ This test checks for hidden (occult) blood in the stool, which can be a sign of cancer or polyps.

⦿ How it works?: You collect a small stool sample at home and send it to a lab for testing. If blood is found, further tests like a colonoscopy may be needed.

⦿ It’s non-invasive and needs to be done annually for effective screening.

Colonoscopy

⦿ A colonoscopy is considered the gold standard for colorectal cancer screening because it allows the doctor to examine the entire colon and rectum.

⦿ During the procedure, a flexible tube with a camera is inserted into the rectum, allowing the doctor to look for abnormalities and remove any polyps found.

⦿ This test is typically done every 10 years if no issues are detected, but more frequently if polyps or other problems are found.

Flexible Sigmoidoscopy

⦿ This test is similar to a colonoscopy but only examines the lower part of the colon and rectum.

⦿ A flexible tube with a camera is inserted to check for polyps or cancer in the lower third of the colon.

⦿ It is less invasive than a colonoscopy and can be done every 5 years, though it may miss cancers higher in the colon.

CT Colonography (Virtual Colonoscopy)

⦿ A CT colonography uses X-rays and computer technology to create detailed images of the colon and rectum.

⦿ This non-invasive test is often referred to as a “virtual” colonoscopy, and it can detect polyps and other abnormalities.

⦿ While it’s less invasive than a traditional colonoscopy, it still requires bowel preparation, and any detected polyps will need to be removed via a standard colonoscopy.

DNA Stool Test

⦿ This is an emerging technology that checks for abnormal DNA in stool samples, which may be linked to cancer or polyps.

⦿ The test can also detect blood in the stool and is usually recommended every 3 years.

⦿ It’s convenient as it can be done at home, but if abnormal results are found, a follow-up colonoscopy will be needed.

There are several screening options available to detect colorectal cancer early, each with its own method and benefits. The table below highlights the different screening tests, how they work, and their recommended frequency:
Screening Test How It Works Frequency Advantages
Fecal Occult Blood Test (FOBT) Detects hidden blood in stool Annually Non-invasive, can be done at home
Colonoscopy Examines the entire colon with a camera, removes polyps Every 10 years Comprehensive, allows polyp removal
Flexible Sigmoidoscopy Examines the lower part of the colon Every 5 years Less invasive, quick recovery
CT Colonography Uses X-rays and computer technology for detailed images Every 5 years Non-invasive, detects polyps
DNA Stool Test Detects abnormal DNA in stool samples Every 3 years Non-invasive, easy to do at home

After a Positive Test

Next Steps After a Positive Result from Screening Tests

⦿ A positive result in a colorectal cancer screening test means that something unusual, such as blood in your stool or polyps, has been detected.

⦿ It’s important to understand that a positive test doesn’t necessarily mean you have cancer.

⦿ The next step is usually a more detailed examination, such as a colonoscopy, to determine the cause of the abnormal result.

The Importance of Follow-Up Tests Like Colonoscopy

⦿ A colonoscopy is the most accurate follow-up test after a positive screening result. It allows the doctor to view the entire colon and remove any suspicious polyps for testing.

⦿ The test is crucial because it helps confirm whether the positive result is due to cancer, polyps, or something else like hemorrhoids or inflammation.

⦿ Without follow-up, you may miss the opportunity to detect cancer early or to remove polyps that could turn into cancer.

Understanding That Not All Positive Results Indicate Cancer

⦿ Many people with a positive screening result do not have cancer. Often, the cause of a positive test is non-cancerous polyps, which can be easily removed.

⦿ Polyps are common, and not all of them become cancerous. By removing them, you can prevent the development of cancer in the future.

⦿ It’s important not to panic but to follow up with your doctor for the recommended tests to get a clear diagnosis.

Prevention Tips For Colorectal Cancer

Importance of a High-Fiber Diet

⦿ A diet rich in fruits, vegetables, whole grains, and legumes is linked to a lower risk of colorectal cancer. Fiber helps in keeping the digestive system healthy by promoting regular bowel movements and removing waste effectively.

⦿ High-fiber foods also contain essential vitamins and antioxidants that help protect the colon from damage.

Staying Physically Active

⦿ Regular physical activity helps reduce the risk of colorectal cancer by improving digestion and maintaining a healthy weight.

⦿ Aim for at least 30 minutes of moderate exercise, like walking or cycling, most days of the week to keep your body healthy and lower your cancer risk.

Avoiding Smoking and Limiting Alcohol Consumption

⦿ Smoking increases the risk of many cancers, including colorectal cancer. Quitting smoking not only lowers your cancer risk but also improves overall health.

⦿ Excessive alcohol consumption can also contribute to colorectal cancer. Limiting alcohol to a moderate level (one drink per day for women and two for men) is advised to reduce this risk.

Regular Health Check-ups and Screenings

⦿ Regular health check-ups allow your doctor to assess your risk factors and recommend appropriate screenings based on your age and medical history.

⦿ Screenings such as colonoscopies are essential for detecting cancer early and preventing it by removing polyps.

Screening Myths & Challenges

Common Fears About the Screening Process

⦿ Many people fear discomfort or embarrassment about undergoing screening, especially for tests like colonoscopy.

⦿ It’s important to know that most screening tests, like the Fecal Occult Blood Test (FOBT), are non-invasive and painless. Even colonoscopies are done under sedation, making the process comfortable for most people.

Myths Like ‘Only Older People Need Screening’

⦿ One common myth is that only elderly people need to worry about colorectal cancer. In reality, people over 45 are at risk, and younger individuals with a family history may need to start even earlier.

⦿ Another myth is that if you don’t have symptoms, you don’t need screening. Colorectal cancer often develops without symptoms, which is why regular screening is crucial.

Encouraging People to Overcome These Barriers

⦿ Educating the public about the safety and benefits of screening is key to overcoming fears and myths.

⦿ It’s important to spread awareness that screening is a preventive tool that can save lives by detecting cancer early or preventing it altogether. Talking to a doctor and getting the right information can help people overcome their concerns and misconceptions.

Frequently Asked Questions
What is colorectal cancer screening, and why is it important?
Colorectal cancer screening is a way to detect cancer or precancerous polyps in the colon and rectum before symptoms appear. Early detection through screening can prevent cancer or catch it early when treatment is most effective, increasing survival rates.
At what age should I start screening for colorectal cancer?
Most people should begin screening at the age of 45, as the risk of colorectal cancer increases with age. However, if you have a family history or other risk factors, you may need to start earlier. Always consult with your doctor to decide the best time for you.
What are the most common screening tests for colorectal cancer?
The most common screening tests include the Fecal Occult Blood Test (FOBT), colonoscopy, and flexible sigmoidoscopy. Colonoscopy is the most comprehensive, as it allows doctors to view the entire colon and remove polyps during the procedure.
How often should I be screened for colorectal cancer?
The frequency of screening depends on the test used. For a colonoscopy, it’s typically every 10 years if results are normal. Other tests like FOBT may need to be done annually or every few years. Your doctor will recommend the best schedule based on your health.
Is colorectal cancer screening painful?
Most screening tests, such as FOBT, are non-invasive and painless. A colonoscopy is performed under sedation, so patients do not feel pain during the procedure. You may experience mild discomfort afterward, but it generally resolves quickly.
What are the symptoms of colorectal cancer?
Colorectal cancer often shows no symptoms in its early stages, which is why screening is important. However, advanced cases may present symptoms like blood in the stool, unexplained weight loss, and persistent changes in bowel habits.
What happens if my screening test is positive?
A positive result means that something unusual has been found, such as blood in your stool or polyps in your colon. Your doctor will likely recommend further testing, usually a colonoscopy, to determine if cancer or another condition is present.
Can I prevent colorectal cancer?
While not all cases can be prevented, adopting a healthy lifestyle—such as eating a high-fiber diet, exercising regularly, avoiding smoking, and limiting alcohol - can lower your risk. Regular screening is also crucial in preventing cancer by detecting and removing polyps early.
What are the risk factors for colorectal cancer?
Risk factors include being over the age of 45, having a family history of colorectal cancer or polyps, certain genetic conditions, inflammatory bowel diseases, obesity, smoking, and a diet high in red or processed meat.
Is screening necessary if I don’t have symptoms?
Yes, screening is necessary even without symptoms. Colorectal cancer often doesn’t show signs until it’s advanced. Regular screening can catch cancer early or detect polyps before they become cancerous, making it easier to treat and improving survival rates.
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Dr. Harsh Shah

MS, MCh (GI cancer Surgeon)

Dr Harsh Shah is a well known GI & HPB Robotic Cancer Surgeon in ahmedabad. He treats cancers of esophagus, stomach, liver, pancreas, colon, rectum & small intestines. He is available at Apollo Hospital.

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