25. Symptoms
Early, usually has no
symptoms
More advanced disease:
rectal bleeding, blood in
stool, change in bowel
habits, lower abdominal
cramping, anemia, weight
loss
32. Benefits of Colorectal Screening
Cancer Prevention-
removal of
precancerous polyps
prevents cancer
Increased Survival- early
detection increases chances of
long term survival.
36. Colorectal Cancer Tests
Yearly Fecal occult
blood test
Yearly Fecal
immunochemical test
Stool DNA test (interval
uncertain)
37. Colorectal Cancer Tests
Flexible CT Colonography
Sigmoidoscopy every (virtual colonoscopy)
5 yrs OR every 5yrs
Colonoscopy every 10
yrs OR
Double Barium
contrast Enema every
5 yrs OR
39. Colonoscope
Thin flexible scope
which is dial controlled
and maneuverable with
fiberoptic video camera.
It also blows air to inflate
the colon, irrigates with
water, suctions, inserts
instruments for removal,
biopsies, cauterization of
polyps skin tissue.
43. Stool DNA Test
Rationale behind:
Detects blood in the stool – which is
intermittent and non-specific
Colon cells are shed continuously
Polyps and cancer cells contain abnormal
DNA
Stool DNA tests look for abnormal DNA from
cells that are passed in the stool*
Drawbacks:
Misses some adenomas
Still in testing phase
Cost ($300-400)
Not covered by all insurance
46. CT
Colonography New Sources of Risk
Colorectal cancer prevention largely focuses
on finding polyps, but flatter, less visible lesions
that are not polyps are also cancer risks.
Limitations:
Polyp
Requires full bowel prep (which most
patients find
Elevated
to be the most distressing element of lesion
colonoscopy)
Colonoscopy is required if abnormalities Flat
detected, lesion
sometimes necessitating a second bowel
prep Depressed
lesion
Steep learning curve for radiologists
Limited availability to high quality exams in The New York Times: Illustrations by JAMA
many parts of the country
Most insurers do not currently cover CTC as
a screening modality
Can miss flat, smaller lesions
48. What is Best For You?
Discuss with your Health Care Provider.
49. What is Best For You?
Discuss with your Health Care Provider.
Unless high risk or symptoms age 50
colonoscopy or discuss other screening
methods.
50. What is Best For You?
Discuss with your Health Care Provider.
Unless high risk or symptoms age 50
colonoscopy or discuss other screening
methods.
Early detection is key! Colon cancer is
preventable.