Colon cancer (tumor in the large intestine) is the third most common type of cancer in the United States. It is expected to cause more than 50,000 deaths during 2021 alone!

Colon cancer usually develops from polyps (abnormal growths) in the colon. Colonoscopy is the most powerful tool for preventing colorectal cancer.  A colonoscopy involves looking at the colon from inside the body using a long, thin (about the width of your finger), flexible tube with a camera on the end. Sedation is given during the procedure to keep the patient comfortable. It can detect, and remove these polyps during the same procedure, and prevent them from progressing towards cancer. 

In short it is a screening, preventive, diagnostic and therapeutic procedure all rolled into one. No wonder it is considered the Gold Standard! A normal colonoscopy usually means no further colon cancer testing for 10 years. 

The U.S. Preventive Services Task Force (USPSTF) recommends that adults older than age 50 be screened for colorectal cancer.

Some patients may need to get tested at an earlier age. Reasons include if:

• You or a close relative have had colorectal polyps or colorectal cancer: start at age 40 or earlier in some situations
• You have an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
• You have a genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).
• You are African-American: start screening at age 45

Fecal Immunochemical Test (FIT)

The stool is collected at home and sent to the lab in a special container. It checks for blood, even when the amount is too small to be seen. Testing every year is essential to help it find early cancers. If it tests positive, you need a Colonoscopy.

COLOGUARD® (STOOL DNA and Blood)

This is an at-home stool test, somewhat like the FIT but much more expensive. Cologuard finds abnormal cell parts, DNA, from colon cancers and advanced polyps and tests for blood in your stool. It needs to be repeated every 3 years. Presence of blood in the stool, even from hemorrhoids, can result in a false positive test. If the test is abnormal, you will need a colonoscopy. COLOGUARD is NOT indicated for high risk groups (family history of colon cancer, personal history of colon polyps, IBD) or symptomatic patients. It is considered the least cost-effective strategy of preventing colon cancer, and its ability to diagnose significant polyps is less than half of that of Colonoscopy.

 CT Colography

This is performed in the radiology department after the patient gets a prep to cleanse the colon. It is usually done in patients who are unable to get a complete colonoscopy done. It has limitations in detecting smaller abnormalities. Because the patient is exposed to significant radiation, it is not used commonly.