One of the most frequent claims of medical malpractice that we handle involves failure to timely diagnose cancer. As with many cancers, early detection of colorectal cancer increases survivability. Since approximately 2000, the American Cancer Society has recommended that men and women at average risk begin routine screening at age 50. It is important to understand that these are very general guidelines for “average risk” patients and that individuals with risk factors require screening at an earlier age.
It is generally recognized that colonoscopy is the most effective diagnostic procedure for colorectal cancer screening. If you are experiencing any of the following symptoms, you should immmediately consult with your physician to determine if a colonoscopy is needed: blood in the stool; change in bowel habits; unexplained stomach discomfort; frequent gas, pains or indigestion.
The following questions and answers, with additional information, can be found at WebMD.
Q: Who should be tested for colorectal cancer?
A: All men and women aged 50 years or older should be tested routinely for colorectal cancer. Others who are at increased risk should speak to their doctors about earlier or more frequent testing. Those at increased risk are people with:
A family history of colorectal cancer or colorectal polyps.
Certain diseases of the intestines, including inflammatory bowel disease (Ulcerative colitis or Crohn’s disease).
Genetic syndromes such as familial adenomatous polyposis (FAP) or hereditary nonpolyposis colon cancer (HNPCC). (Just 5% of colorectal cancers are linked to these genetic syndromes).
Q: Why should I get screened?
A: Screening saves lives. Having regular screening tests beginning at age 50 could save your life. Colorectal cancers almost always develop from precancerous polyps (abnormal growths) in the colon or rectum. Screening tests can find polyps, so they can be removed before they turn into cancer. Screening tests also can find colorectal cancer early, when treatment works best and the chance for a full recovery is very high.
Q: What are the symptoms of colorectal cancer?
A: Colorectal cancer develops with few, if any, symptoms at first. However, if symptoms are present, they may include:
blood in or on the stool
a change in bowel habits
stools that are narrower than usual
general, unexplained stomach discomfort
frequent gas, pains, or indigestion
unexplained weight loss
These symptoms can also be associated with other health conditions. If you have any of these symptoms, discuss them with your doctor. Only your doctor, through testing, can determine why you’re having these symptoms.
Q: What are the screening tests for colorectal cancer?
A: Several tests can be used to screen for colorectal cancer. These tests are used alone or in combination with each other
Fecal Occult Blood Test (FOBT) – A test that checks for occult (hidden) blood in the stool. At home, using a small stick from a test kit, you place a small amount of your stool, from three bowel movements in a row, on test cards. You return the cards to your doctor’s office or a lab, where they’re checked for blood. This test is recommended yearly. (If blood is found, you likely will need a follow-up colonoscopy.)
Flexible Sigmoidoscopy – Before this test, you use a strong laxative and/or enema to cleanse the colon. Flexible sigmoidoscopy is conducted at the doctor’s office, a clinic or a hospital. The doctor (or other specially trained health professional) uses a narrow, flexible, lighted tube to look at the inside of the rectum and the lower portion of the colon. During the exam, the doctor may remove some polyps (abnormal growths) and collect samples of tissue or cells for closer examination. This test is recommended every 5 years. (If polyps are found, you will need a follow-up colonoscopy.)
Combination of Fecal Occult Blood Test (FOBT) and Flexible Sigmoidoscopy – Some doctors recommend having both tests to increase the chance of finding polyps (abnormal growths) and cancers. When used in combination with each other, FOBT is recommended yearly and flexible sigmoidoscopy is recommended every 5 years.
Colonoscopy – Before this test, you will take a strong laxative to cleanse the colon. Colonoscopy is conducted in a doctor’s office, clinic, or hospital. You are given a sedative to make you more comfortable, while the doctor uses a narrow, flexible, lighted tube to look at the inside of the rectum and the entire colon. (This test is similar to flexible sigmoidoscopy, except the tube used is longer and allows the doctor to see the entire colon.) During the exam, the doctor may remove some polyps (abnormal growths) and collect samples of tissue or cells for closer examination. This test is recommended every 10 years. (Colonoscopy is also used as a follow-up test if anything unusual is found during one of the other screening tests.)
Double Contrast Barium Enema – This test is conducted in a radiology center or hospital. Before the test, you use a strong laxative and/or enema to cleanse the colon. This procedure involves taking X-rays of the rectum and colon after you are given an enema with a barium solution, followed by an injection of air. The barium coats the lining of the intestines so that polyps and other abnormalities are visible on the X-ray. (If polyps are found, you will need a follow-up colonoscopy.)