Submitted By Dr. Darley Solomon*
Colorectal cancer screening tests
In many cases, these tests can find colorectal cancers at an early stage and greatly improve treatment outcomes. Screening tests can help prevent some cancers by allowing doctors to remove polyps that might become cancer.
In general, both men and women at average risk of colorectal cancer should begin screening tests at age 50. You should talk with your doctor to choose the best screening plan for you.
Be sure your doctor knows about any medicines you are taking prior to your screening, as you may need to change how you take them before the test.
Tests that can find both colorectal polyps and cancer
Flexible sigmoidoscopy (flex-sig)
A sigmoidoscope is a thin, flexible, lighted tube. It is put into the lower part of the colon through the rectum and allows the doctor to look inside for cancer or polyps.
You will need to take medicine to clean out your colon so that the doctor can see the lining.
A sigmoidoscopy takes 10-20 minutes. If a small polyp is found the doctor may remove it during this test. If an adenoma polyp or colorectal cancer is found, you will need to have a colonoscopy to look for polyps or cancer in the rest of the colon.
A colonoscope is a longer version of the sigmoidoscope which allows the doctor to see the whole colon.
Before the test: You cannot eat for a certain time and will need to take medicine to clean out your colon prior to the test. You may need an enema.
During the test: The test itself takes 30-45 minutes. Before the test begins, you will be given medicine to make you feel comfortable and sleepy. You might be awake, but you will not be aware of what is going on and most likely won’t remember the test afterward.
If a growth is found, the doctor may remove it and a biopsy may be done. The tissue is examined under a microscope to see whether it is cancer, a non-cancerous growth, or a result of inflammation.
After the test, you will need to have someone drive you home because the medicine used can leave you groggy.
Some patients may experience low blood pressure or abnormal heart rhythms from the drugs used during the test.
If a polyp is removed, you may notice some blood in your stool for a few days.
Rarely, the colonoscope can puncture (perforate) the wall of the colon and surgery might be needed.
Double contrast barium enema (DCBE)
The bowel preparation for this test is much like that for the colonoscopy. The test takes 30-45 minutes. A small, flexible tube is put into the rectum, and barium sulfate is pumped in to partly fill and open up the colon. Air is pumped into the colon through the same tube so the barium spreads throughout the colon.
X-ray images are taken of the digestive tract. If an area looks abnormal you will need to have a colonoscopy.
You may have bloating or cramping after the test and will likely feel the need to empty your bowels soon after the test is done. You may experience constipation and your stool may look different for a few days until the barium is out.
In this test, the CT scanner takes pictures as it rotates around you. A computer then combines these pictures into images of the colon and rectum which allows the doctor to look for abnormalities.
This test requires the same type of bowel preparation as a colonoscopy and a short tube will be put in your rectum to fill your colon with air.
If problems are seen, a colonoscopy will be needed.
Tests that mainly find colorectal cancer
These tests are used to find small amounts of blood in the stool. You will need to collect samples of your stool to be sent to a lab for testing.
If you are having one of these tests, the doctor or nurse will give you a kit with exact instructions on what to do.
A positive result on one of these screening tests will likely mean you will need a colonoscopy.
“CTMH is pleased to act as a complete colorectal cancer screening and treatment facility,” Dr. Solomon said. “We are pleased to offer the above outpatient screening and diagnostic procedures, as well as on-island care for cancers.”
*Information from the American Cancer Society
Dr. Darley Solomon MD MBA Dr. Darley Solomon is an attending General Surgeon who has been practising at Doctors Hospital since 2011. Dr. Solomon earned his Bachelor of Science in Chemistry and Doctor of Medicine degrees at Howard University in Washington, DC. He then completed an internship in Internal Medicine at Jacobi Medical Center in […]Read More
Dr. Darley SolomonGeneral Surgeon