Colorectal Cancer Screening and Diagnosis

Colorectal cancer screening is one of the most important things people can do for their health. Detecting cancer early through screening drastically changes how treatable colorectal cancer is. Screening could even save a person’s life.

If colorectal cancer screening tests show abnormal results, or if a patient is experiencing colorectal cancer symptoms, our doctors will recommend tests to find the cause. We use the latest diagnostic technologies to help ensure an accurate diagnosis and, if necessary, the most effective treatment for colorectal cancer.

Screening

Traditionally, patients were first screened for colorectal cancer at age 50. However, with the rise in colorectal cancer in the younger population, that age has been lowered to 45 years. People with a personal or family history of colorectal cancer or colon polyps may need to start screening at an even younger age.

A colonoscopy is considered the gold standard for screening and diagnosing colorectal cancers and polyps.

Patients who are unwilling or unable to undergo a colonoscopy may choose to get an alternative test:

• Fecal immunohistochemical test (FIT), fecal occult blood test (FOBT), or stool DNA test. These are simple stool-based tests but are not as effective at finding cancer as a colonoscopy. The tests are useful for detecting cancers but not polyps. A positive stool test will require a colonoscopy to locate and biopsy the cancer.
• Computed tomography (CT) colonography. This is an evaluation of the colon by using a CT scan. It is not very effective for finding smaller polyps.
• Flexible sigmoidoscopy. This involves inserting a flexible tube with a camera into the rectum and evaluating the rectum and the left side of the colon. In this test, a full bowel preparation is not necessary, but the tradeoff is that the right side of the colon is not evaluated.

A colonoscopy, CT colonography, and flexible sigmoidoscopy can detect both polyps and cancer.

Diagnosis

Once a cancer diagnosis has been made, our radiologists note the characteristics and stage of the tumors with state-of-the-art imaging techniques, including magnetic resonance imaging (MRI), a CT scan, positron emission tomography (PET), or a combination of these techniques. We use tailored imaging protocols to determine the stage of cancer at the time of diagnosis and after patients undergo chemo- and radiation therapy.

Our patient care team includes specialized radiologists who use established criteria for interpreting and recording the results of imaging scans. This allows for improved communication between team members.

Our multidisciplinary team includes surgeons, oncologists, radiation oncologists, radiologists, and pathologists who meet every week to discuss cases and devise an individualized care strategy for each patient. Patients who undergo cancer surgery routinely have follow-up examinations and imaging scans to check on their cancer status.