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Recommended Screening
Warning Signs & Symptoms
You should begin colorectal cancer screening earlier and/or undergo screening more often than these recommendations if you have any of the following colorectal cancer risk factors:
- A strong family history of colorectal cancer or polyps (cancer or polyps in a first degree relative younger than 60 or in two first degree relatives of any age),
- Families with hereditary colorectal cancer syndromes (familial adenomatous polyposis and hereditary non-polyposis colon cancer),
- A personal history of colorectal cancer or adenomatous polyps, or
- A personal history of chronic inflammatory bowel disease.
Recommended Screening
| Test or Procedure |
Who should be tested? |
How often? |
Sigmoidoscopy
A slender, flexible, hollow, lighted tube is placed into the rectum. This allows the doctor to look at the inside of the rectum and part of the colon for cancer or for polyps. Polyps are small growths that can become cancerous. This test may be somewhat uncomfortable, but it should not be painful.
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Men and Women
50 years and older
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Every 3-5 years |
Fecal Occult Blood Test
A sample of stool is examined for blood. A test kit will explain how to take a sample at home. It is then returned to the doctor's office to be checked.
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Men and Women
50 years and older |
Annually |
Colonoscopy
A colonoscope is a long, flexible, lighted tube about the thickness of a finger. It is inserted through the rectum up into the colon. A colonoscope is much longer than a sigmoidoscope, and allows the doctor to see much more of the colon's lining. The colonoscope is connected to a video camera and video display monitor so the doctor can look closely at the inside of your colon.
If a polyp is found, the doctor may remove it. Polyps, even those that are not cancerous, can cause bleeding. For this reason, they are usually removed. This is done by passing a wire loop through the colonoscope to sever the polyp from the wall of the colon using an electrical current. The polyp can then be sent to a lab to be checked under a microscope to see if it has any areas that have changed into cancer.
If the doctor sees anything else abnormal, a biopsy may be done. To do this, a small piece of tissue is taken out through the colonoscope. Examination of the tissue can help determine if it is a cancer, a benign (non-cancerous) growth, or a result of inflammation. Colonoscopy usually does not cause pain, although it may be uncomfortable. The doctor will give you some medicine through a vein to make you feel relaxed and sleepy. Before having the test, you will be told how to cleanse your colon so that there will not be any stool to block the view.
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Men and Women |
Every 10 years |
Barium Enema with Air Contrast (Also called a double contrast barium enema)
You will be given barium sulfate, a chalky substance used to partially fill and open up the colon. The barium sulfate is given in the anus. When the colon is about half-full of barium, you will be turned on the x-ray table so that barium spreads throughout the colon. Then air is inserted to cause the colon to expand. This allows good x-ray films to be taken. Before this test, you will be told how to cleanse your bowel the night before and the morning of the exam.
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Men and Women
50 years and older |
Every 5-10 years |
Digital Rectal Exam
The doctor or health care provider inserts a gloved finger into the rectum to feel for anything not normal. This simple test, which is not painful, can detect many rectal cancers.
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Men and Women
40 years and older |
Annually and at the time of every test listed above |
Warning Signs and Symptoms
People who have any of the following symptoms should check with their doctor, especially if they are over 40 years old or have a personal or family history of the disease:
- A change in bowel habits such as diarrhea, constipation, or narrowing of the stool that lasts for more than a few days;
- A feeling that you need to have a bowel movement that is not relieved by doing so;
- Rectal bleeding or blood in the stool;
- Cramping or steady abdominal (stomach area) pain;
- Decreased appetite;
- Weakness and fatigue;
- Jaundice (yellow-green discoloration of the skin and white part of the eyes).
Other conditions such as infections, hemorrhoids, and inflammatory bowel disease can also cause these symptoms. But it is important to talk to the doctor since finding colorectal cancer early makes successful treatment more likely. It is also possible to have colon cancer and not have any symptoms. If the doctor suspects colon cancer, more tests will need to be done.
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