Colon cancer is the second most common cause of cancer-related death in the United States. The average American has an approximate 6% lifetime risk for developing colon cancer. However, with appropriate screening, this disease is highly preventable.
Colon cancer is a relatively slow-growing cancer usually beginning as a benign growth or polyp. Because of this characteristic, screening for pre-malignant growths (polyps) affords an excellent potential for prevention or cure of this otherwise deadly disease.
Screening exams are generally done before an individual has experienced symptoms or warning signs.
Warning signs may include:
- Blood in Stool
- Change in Bowel Habits
- Weight Loss and/or Fatigue and may indicate more advanced disease.
The physicians at Atlantic Digestive Specialists conduct colon cancer screenings in several ways.
Barium enema is an X-ray of the colon that provides a two-dimensional look at the colon and will locate tumors, polyps, and diverticulosis, but may miss small to medium-size polyps. Therefore, a visual inspection of the colon via colonoscopy assures us of an optimum view of the colon for detection of polyps.
Sigmoidoscopy is a short version of the colonoscopy. It is usually done in the office without sedation and can view the lower third of the colon. This test can be performed relatively quickly and inexpensively in the office setting. A minimal prep is required prior to this procedure. Because there is no sedation for this test, patients do not need to arrange for a ride home and can resume regular activity immediately. Sigmoidoscopies generally do not require a pre-procedural visit with the physician at Atlantic Digestive Specialists.
The fecal immunochemical test (FIT), also called an immunochemical fecal occult blood test (iFOBT), is a newer stool test that also detects hidden blood in the stool. This can be a sign of precancerous polyps or colon cancer because blood vessels at the surface of larger polyps or cancers are often fragile and are easily damaged by passing stool. The damaged blood vessels usually release a small amount of blood into the stool, but only rarely is there enough bleeding to be visible in the stool, which is why these tests are helpful. Checking stool for ‘occult’ or microscopic blood is a very inexpensive, easy test; however, this test lacks accuracy.
A colonoscopy allows the physician to examine the entire colon. This test is performed in a hospital or surgery center setting with sedation. Although this test is more thorough, it is more expensive. A brief stay of 2 – 4 hours may be necessary at the hospital short stay unit, although the test itself may only last for 20-30 minutes. Additionally, patients will have to arrange for a ride home and will be unable to drive for 24 hours after the sedation.
There is currently some controversy over which test is best for an individual with no risk factors for colon cancer. For patients with no known risk factors, debate is ongoing as to whether or not the additional view of the entire colon supports the extra cost of a colonoscopy compared to a sigmoidoscopy.
Many public media sources advocate a full colonoscopy in lieu of a sigmoidoscopy. The American College of Gastroenterology also advocates a complete colonoscopy for people at average-risk for colon cancer to be performed every 10 years. Typically, average-risk people do not have any first-degree relatives with colon cancer or pre-malignant polyps. Average-risk people also have no personal history of colon cancer, colon polyps, inflammatory bowel disease, nor any other worrisome symptoms.
The current standard recommendation in average-risk people is a routine sigmoidoscopy performed every 3 – 5 years, or a colonoscopy every 7 – 10 years. Medicare now covers routine screening colonoscopy every 10 years, provided a screening exam such as a sigmoidoscopy has not been performed within the prior four years. Some private insurers also offer screening colonoscopy coverage for individuals at average risk. Most insurers offer coverage for individuals at high-risk.
The physicians of Atlantic Digestive Specialists believe that it’s reasonable to do either test as a screen for colon cancer. If you desire a colonoscopy and do not have any risk factors or symptoms to support this as a covered procedure through your insurance company, your physician at Atlantic Digestive Specialists will utilize the following guidelines:
- Patient must be in an appropriate age group.
- A preliminary office consult usually is not required.
- Payment arrangements must be made prior to procedure being scheduled if your insurer will not cover this procedure.
- If your insurance plan requires a referral, notify your primary care physician’s office prior to scheduling your procedure.
- The risks, complications or any adverse consequences possibly associated with your procedure will be reviewed with you by your gastroenterologist at the hospital or surgery center prior to your procedure. To view a sample of a Preliminary Consent Form, please click HERE or contact our office.
At Atlantic Digestive Specialists you will benefit from the personal care and technologically advanced procedures performed by our leading, board-certified gastroenterologists. Contact us for more information on colon cancer screening.