Colon and Rectal Cancer Detection & Diagnosis
Many patients don’t know they have colon or rectal cancer until it’s advanced and more difficult to treat. Thankfully, screening is available for colorectal cancer, resulting in better outcomes for many patients. Colorectal cancer screening is somewhat uncomfortable to talk about, but it can save your life!
Even if you feel perfectly healthy, the Virginia Oncology Associates cancer specialists recommend following the American Cancer Society’s guidelines for colorectal cancer screening, starting at age 45. The average age of diagnosis has lowered from age 72 in 2002 to age 66 in 2019, making screening at an earlier age key for catching polyps that could turn into cancer later.
Learn more in our blog: Colon Cancer Screening Age Lowered to 45 - How Does This Affect You?
Common Types of Screening for Colon and Rectal Cancers
Several methods for detecting colorectal cancer are available. Some tests can be done at home, while others, such as a colonoscopy, are performed in a healthcare facility. The right screening method depends on your age and risk of developing colon or rectal cancer. It's wise to schedule an appointment with your primary care physician to learn more about your screening options.
At-Home Colorectal Cancer Screening Tests
At-home testing is acceptable for those who are at average risk of developing colon cancer. If you have a family history or several risk factors, a colonoscopy rather than an at-home kit will be recommended.
There are a few types of at-home screening tests. The most common is the Fecal Immunochemical Test (FIT or iFOBT). The most popular brand is Cologuard®. The test is considered preventive care, and most insurance companies fully cover the cost.
Once you send in the stool sample according to the instructions in the box, the test will show if there is blood in the stool or not. If blood is present, this indicates further testing is needed.
This test alone does not diagnose cancer and is not foolproof. False positive results can occur, which indicate abnormalities in your test results when none are present.
If there is blood in the stool, it could be undetectable to the eye during a bowel movement. That’s why the FIT test is so helpful. It can detect even small amounts of blood from a polyp or tumor in the colon or rectum.
Related reading: 5 Important Things You Need To Know About Colorectal Cancer and At-Home Tests
Colonoscopy Screening
A colonoscopy is often the preferred screening method for detecting colon and rectal cancer since it allows the doctor to view the entire colon. According to the National Cancer Institute, studies show that colonoscopy screenings can reduce colorectal cancer deaths by 60-70%. A doctor performs the test at a medical facility. You must prepare your colon a day or two before the test. Special laxatives are provided to help you clean out your colon so the doctor can see if there are polyps.
A flexible, lighted tube called a colonoscope is inserted into the rectum and the lower colon during a colonoscopy. You will be sedated for the procedure. The tube has a lens for viewing and a tool for removing tissue. Air is pumped into the rectum to help the doctor examine the colon lining more clearly. If any abnormal growths are found, they can be removed for testing during the procedure. Additionally, tissue samples may be taken for further examination.
Who Should Start Colorectal Cancer Screening Early?
Due to rising cases of colon and rectal cancers among younger adults, the American Cancer Society (ACS) lowered the recommended screening age from 50 to 45. Researchers are actively studying this increase in cases among younger individuals, with several contributing factors being identified, including poor diets, lack of physical activity, and obesity.
Screening recommendations for colon and rectal cancer vary based on an individual's risk level. Patients at average risk typically have no family history of colorectal cancer and are generally healthy. For these individuals, the ACS recommends thorough screening every ten years.
Patients at high risk for colorectal cancer often have one or more risk factors, such as:
- A family history of colon or rectal cancer
- Issues related to inflammatory disease
- Previous radiation treatment to the pelvic area for another cancer
According to the ACS, high-risk individuals should begin screening earlier and more frequently than those at average risk. Regular screening is crucial for prevention, especially for those at high risk of developing colon or rectal cancer.
Read our blog: Colorectal Cancer Risk Factors: Who Is at Risk?
Abnormal Test Results? What to Expect Next
Confirming a diagnosis of colon or rectal cancer requires further testing. If any test other than a colonoscopy indicates abnormalities, a doctor may order a colonoscopy to view the entire colon. If cancer is suspected during the colonoscopy, the doctor will most likely remove the polyp and send it in for further testing by a pathologist. If it is too large to remove right away, or if cancer is suspected, a second colonoscopy, called a diagnostic colonoscopy, is performed.
The pathologist evaluates the sample to see if cancer cells are present. If they are, additional tests will guide the diagnosis and staging process.
- Blood tests: Your doctor will check for tumor markers and other substances in the blood that indicate cancer is present.
- Endorectal ultrasound: An ultrasound probe is inserted into your rectum. This probe emits sound waves that cannot be heard. The waves bounce off your rectum and surrounding tissues, and a computer uses the echoes to create an image. This image can show how deep a rectal tumor has penetrated or whether cancer has spread to nearby lymph nodes or tissues.
- MRI: This method uses magnetic fields, rather than X-rays, to produce detailed images of the body. You may receive an injection of a contrast medium to enhance the clarity of the picture. MRI is the most effective imaging test for determining the extent of colorectal cancer.
- CT scan: A CT scan uses an X-ray machine connected to a computer to take detailed pictures of areas inside your body. You may receive an injection of dye. A CT scan can show if cancer has metastasized to the liver, lungs, or other organs.
- PET-CT scan: A PET scan utilizes small amounts of radioactive material, a special camera, and a computer to create images of internal organs and tissues. When a PET scan is combined with a CT scan, it is called a PET-CT scan.
- Biomarker testing: If cancer is found, additional tests will be run on the tissue sample to look for genetic mutations that could give the oncologist a more direct path for successfully treating your specific diagnosis. The tests identify particular genes with mutations known to lead to cancer. Some drugs are available to counteract these mutations.
It's important to note that not all colon polyps are cancerous. Try to remain calm until you meet with your doctor. If pathology testing of polyps removed during a colonoscopy confirms a cancer diagnosis, your doctor will work to determine the stage of the colorectal cancer. Understanding whether the cancer has spread is essential for establishing the stage of the disease.
Colorectal Cancer Care at Virginia Oncology Associates
Staying up to date with your colorectal screenings is an important way to be proactive about your health. The good news is that when colorectal cancer is detected through colorectal cancer screening, it’s usually identified early when it’s smaller and easier to treat.
If a biopsy of your polyp confirms you have colorectal cancer, schedule an appointment with a colon cancer doctor at Virginia Oncology Associates. Our team is here to answer your questions and create a personalized colorectal cancer treatment plan tailored to your needs. We also offer second opinions as you begin to make your treatment decisions.
Virginia Oncology Associates has multiple locations across Virginia and Eastern North Carolina, including Chesapeake, Elizabeth City, Hampton, Newport News, Norfolk, Suffolk (Obici and Harbour View), Virginia Beach, and Williamsburg.