Colorectal Cancer Screening Options

 

Understanding Screening

Colorectal cancer (CRC) is common—even in people who have no history of the disease in their family. In many cases, CRC does not cause bleeding or other symptoms until it is in a late stage that is difficult to cure. For these reasons, prevention is key. Typically, CRC starts as a small precancerous growth which takes years to become a true cancer. Discovery and removal of precancerous growths, or polyps, often prevent cancer from developing. If you follow your doctor’s advice and have proper screening, your chance of getting colon cancer is likely to decline significantly.

Screening Options

There are several options for CRC screening. None of the options is perfect in all aspects and the various screening tests differ in accuracy, safety, convenience, availability and cost. MAGIC follows the US Multi-Society Guidelines for colorectal cancer screening. These guidelines are set by representatives from the American Cancer Society, the US Multi-Society Task Force, and the American College of Radiology.

The following tests are included in these guidelines and are offered by MAGIC:

  • Traditional (Optical) Colonoscopy
  • Integrated CT Colonography
    (Virtual Colonoscopy with same day polyp removal if polyp is found—15% chance of polyp for patients at average risk)
  • Fecal Occult Testing (Stool test for blood)
  • Fecal DNA Testing (Stool genetic test for cancer)
  • Flexible sigmoidoscopy

Advantages and Disadvantages of CRC Screening Tests          [ click (+) to expand ]

Traditional/Optical Colonoscopy
ADVANTAGESDISADVANTAGES
Highly AccurateRequires prep
Polyps removed same day (during test)No driving until day after test
There are known risks
Requires IV and sedatives/anesthesia
Integrated CT Colonography (Virtual Colonoscopy)
ADVANTAGESDISADVANTAGES
Highly AccurateRequires prep
State of DE mandates coverage by commercial insurersMedicare does not yet universally cover routine screening
No known risk
No IV or sedative are required
No driving restrictions
Non-invasive
No pain from trapped air when CO2 protocol used
Test is quick—ten minutes
Polyps can be removed same day (*)
*Polyps are found in approximately 15% of patients who are at average risk for CRC. If polyps are found, most patients are offered same day colonoscopy
Fecal Occult Testing (Stool test for blood)
ADVANTAGESDISADVANTAGES
Can be done at homeColon is not seen
Low costLow accuracy
No prep required
Fecal DNA Testing (Stool genetic test for cancer)
ADVANTAGESDISADVANTAGES
No prep requiredCan detect cancer once it occurs (but cannot detect precancerous polyps)
Colon is not seen
Not covered by all insurers
False Positive results in 10% of cases
Flexible Sigmoidoscopy
ADVANTAGESDISADVANTAGES
Less aggressive prepDoes not visualize entire bowel
Can be done without sedationMisses many growths