What does it mean to be “screened” for colorectal cancer? What is a screening colonoscopy? How is this different from a diagnostic colonoscopy or surveillance colonoscopy? All this terminology is confusing!

  • Being screened for colorectal cancer is the best way to reduce your risk for late-stage disease, and optimize your outcomes should a cancer be detected.

  • Screening means looking for a disease when symptoms aren’t present. 

  • If you have symptoms like anemia, blood in your stools or a change in your bowel habits, diagnostic tests (including colonoscopy) may be recommended to determine a cause of your symptoms.  

  • Screening options for colorectal cancer may include: 

  • Stool studies or Fecal immunochemical test (FIT) tests to look for occult blood (or blood not seen by the naked eye) in your stool

    • This involves wiping a small amount of stool onto a test card and submitting it to a lab.

    • While these tests are sensitive screening methods, they’re not specific for picking up polyps or cancer. They might be positive with other conditions like hemorrhoidal bleeding.  

  • Stool DNA tests like Cologuard®

    • Again, this involves simply submitting a stool sample; however, this test does carry the risk of false positive and negative results, and if the test is positive a colonoscopy will still be necessary to determine the cause of the positive result.

  • Virtual CT colonography (or virtual colonoscopy)

    • Cross sectional imaging is used to identify ulcers, polyps and cancers.

    • Virtual colonoscopy is fairly non-invasive. It doesn’t require anesthesia or sedation; however, it does not allow for the removal of polyps or any other treatment during the procedure. If polyps or other lesions are found, colonoscopy will still be required to remove or treat these findings. 

  • COLONOSCOPY remains the gold standard for colorectal cancer screening.

    • It allows us to BOTH identify and remove polyps, and diagnose cancer or dysplastic changes. 

COLONOSCOPY is an outpatient procedure performed under anesthesia where an endoscope, or thin, flexible, tube with a camera and light attached to the end of it, is passed through the anus and rectum and into the entire large intestine (or colon), including the sigmoid (or pelvic colon), the descending colon, transverse colon, ascending colon and cecum (a pouch forming the first part of the large intestine that connects with the small intestine). Colonoscopy can be used to find polyps, colon and rectal cancers, ulcerations, irritated tissue and inflamed tissue. 

Prior to the procedure, patients take a “bowel prep” intended to flush out the contents of the large intestines so that the lining of the colon can be visualized and any abnormalities in the wall of the colon, including polyps, can be identified. 

If any polyps are discovered, these can be removed, and biopsies can be taken of any suspicious tissue, during the procedure. 

The procedure is safe and typically takes less than 45 minutes to complete. 

COLONOSOCPY is an ideal screening test, because it allows us to BOTH detect and remove colon polyps all at once.

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Hunterdon Digestive Health Specialists


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