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[S172]Screening For Colon Cancer

by Groshan Fabiola, Gro

There are several choices for colon cancer screening that one can choose from. Flexible sigmoidoscopy, FOBT, a combination between those two, colonoscopy or barium enema are the screening options for colon cancer. As you can imagine, all these options have their advantages and disadvantages. These can differ from a colon patient to another. There are some factors that have to be taken into consideration when a colon cancer patient chooses one of these strategies:
- the preference of the colon cancer patient;
- medical contraindications;
- adherence;
- the resources that are available for testing;
The clinic where the patient goes to do the screening for colon cancer should also talk to people about benefits and also about the risk that the colon cancer patient must face in each of these options that are available to him.

The screening intervals depend from a test to another. For example, if you choose the FOBT test for colon cancer, an annual screening is recommended. It is proved to reduce the rate of mortality. However, this colon cancer screening type unfortunately gives a lot of false- positive results. If colonoscopy is your choice, then this colon cancer screening must be done once in ten years. A shorter period of time, about five years, is recommended in barium enema. The reason is that this colon cancer screening option is thought to have a lower sensitivity. However, besides FOBT, all the other colon cancer tests can be done in shorter intervals as well, because studies have revealed that some of these tests can be effective even when done in those shorter intervals.

The age that both men and women should start screening for colon cancer is 50 years, because there is a great incidence of colon cancer above this age. However, if one of your family members is diagnosed with colon cancer, then it would be best for you to start screening even if you have not yet reached 50. There is no certain age when screening for colon cancer must be discontinued. However, in general, screening for colon cancer has been restricted to people that are older than 80 years.

The cost of these colon cancer screening tests also varies from a test to another. Colonoscopy is generally thought to be the most expensive of all these tests, but also the most sensitive. Furthermore, if colonoscopy is your choice, then you should know that this colon cancer screening tests also requires highly trained doctors besides the cost.

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There is little data on when to start screening for colon cancer or when to stop. Each of these tests for colon cancer usually give better results at different ages. For example, the FOBT colon cancer screening test is more effective for people that are between fifty and eighty years old. On the other hand, sigmoidoscopy, another colon cancer screening test has been proven more effective if started at the age of forty five. However, there are also some studies that indicate that if you start screening for colon cancer at the age of forty and not at fifty, your life expectancy will only increase by one day. So, there are many debates on what is the right age to start screening for colon cancer, but there are no sure results so far.

These screening options for colon cancer have some harms, but the risk of actually reaching them is very little. In FOBT, the false- positive results that can often occur can lead to some more invasive procedures, such as colonoscopy. However, there is little chance of this happening, because this colon cancer screening test is known to give false- positive results. Sigmoindoscopy can also pose threat on the colon cancer patient, although the risk of this happening is very little as well. This test for colon cancer can lead to a perforation of the bowel. When using this screening option, there are also some adverse effects that the colon cancer patient can suffer from. Some of the people that chose this test complained of pain, bleeding, anxiety or flatus. However, no one of the patients that participated in a study involving this colon cancer screening had any perforations.

Another screening test for colon cancer is called barium enema. Surveys have also been done in this case as well. Results were very good. It seems that only one colon cancer patient in ten thousand actually suffered from any complications. Furthermore, only one person out of twenty five thousand colon cancer patients actually suffered from perforation and out of fifty five thousand patients, only one colon cancer patient has died. Another screening option for colon cancer patients is colonoscopy. However, this is more dangerous than the other tests, because it is a more invasive procedure.

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