Colorectal Cancer Screening and Diagnosis

Specialists at UMMC perform routine and advanced testing to detect cancers in the digestive tract sooner, when it’s more treatable. Screenings should begin at age 50 for most people, and at 45 for African-Americans. Others who are at high risk also may need screening earlier.

A common test to detect colon or rectal cancer is a colonoscopy. This test allows doctors to look for signs of cancer and other gastrointestinal (GI) conditions and remove polyps if they find them. Removing benign (non-cancerous) polyps can help prevent them from becoming malignant (cancerous).

Recommended colorectal cancer screenings include:

• Blood and fecal tests
• Endoscopic tests
• Fluoroscopic test

Screening appointments and locations

Your primary care physician will recommend a procedure that is best for you and your health conditions and when to start annual screening. Screenings can be done at UMMC Gastroenterology.

• For appointments, call (601) 984-4540
• Referring physicians may call (866) UMCC-DOCS (866-862-3627).

Our locations

• Pavilion – University Physicians

Screening recommendations and risk factors

Men and women with certain colorectal risk factors, such as previous colon polyps or close relatives with colon cancer or polyps, should start screening tests at an earlier age. Talk to your doctor about what is appropriate for you.

Colonoscopy: Recommended every 10 years with no increased risk factors but more frequently if risk factors or present. Your doctor can clarify what is best for you.

Some hereditary conditions that increase risk of colon or anal cancers include:

• A family history of colorectal cancer or polyps in a first-degree relative
• A family history of hereditary colorectal cancer syndromes such as familial adenomatous polyposis FAPP) and hereditary non-polyposis colon cancer HNPCCC)
• A personal history of colorectal cancer or adenomatous polyps
• A history of chronic inflammatory bowel disease such as Crohn's disease

Types of colorectal cancer screening

Blood and fecal tests

Doctors may use these annual tests to look for signs of colon cancer and other conditions. They precede a colonoscopy, and can be requested from any primary care provider.

• Fecal occult blood test: Recommended as an annual test to check for blood in the stool. Bleeding can be one symptom of colon cancer. It also may indicate other conditions, so it cannot he used to diagnose colon cancer.
• Fecal immunochemical test: Another annual test similar to a fecal occult blood test but does not require patients to restrict diet or medications beforehand.
• Stool DNA: This test checks a stool sample for specific changes in DNA that may indicate colorectal cancer.

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Endoscopic tests

These tests use a thin, tube-like instrument with a light and lens to allow doctors to see inside the digestive tract, respiratory tract, chest, or abdomen. Doctors also can use tools inserted through this tube to remove tissue samples for biopsy or to remove abnormal tissue. If doctors are looking into the chest or abdomen, they may make small cuts to insert the scope and other small cuts to insert other tools. If cancer in the GI tract appears to be spreading, doctors may recommend looking into the lungs, chest, or abdomen.

• Anoscopy: This procedure is used to help detect anal cancers. The doctor uses a short, lighted tube anoscope) to examine and biopsy the anus.
• Colonoscopy: A colonoscope - a long, flexible, lighted tube - is inserted through the rectum and into the colon. The tube allows the physician to see the lining of the colon and to use tools in the scope to remove polyps and tissue for further examination. The day before a colonoscopy, patients must complete a colorectal cleansing regimen to empty the digestive tract.
• Flexible digmoidoscopy: The doctor inserts a short, flexible, lighted tube sigmoidoscope) into the intestine through the rectum. The scope blows air into the intestine to inflate it and make it easier to see the inside of the colon and lower one-third of the large intestine. Images and biopsies can be taken with this procedure.

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Fluoroscopic test: Barium enema

Also called a lower GI series, this exam allows the doctor to see the inside contour, shape, and size of the colon in motion. The large intestines are filled with a barium liquid while X-rays are being taken. Doctors may recommend a double contrast image in which barium and air are introduced. This test will show very small surface abnormalities.

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