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The Bottom Line on Colon Cancer: Get Screened
Date:3/4/2011

st (FOBT): This is a safe and simple test and is most effective if done annually. It involves a take-home kit available from the doctor's office that tests for the presence of blood in the stool. The downside to FOBT is it is not specific to detecting cancer, just blood, which can be a symptom of colon cancer. FOBT has a high false-positive rate. If blood is detected in the stool, the patient will be referred for a sigmoidoscopy or colonoscopy.

* Flexible sigmoidoscopy: Similar to a colonoscopy in that a flexible tube is inserted into the colon via the rectum. A scope looks for growths called polyps on the membrane wall; polyps can be precursors to cancer. Although this test only needs to be done once every five years, it does not examine the entire colon and does not have the ability to remove any polyps that are found.

* Colonoscopy: The current "gold standard" of screening tools, according to Grady, because it only needs to be done once every 10 years in people of normal risk. The scope examines the entire colon and contains a tool to painlessly remove polyps instantly. The downside is mostly the perception that preparing for the test and the exam itself are uncomfortable. However, the process of emptying the colon in advance of the test - taking a special laxative - can be done at home in two parts prior to coming to the clinic for the exam. Patients are usually sedated for the 15-30-minute colonoscopy itself and usually feel nothing.

* Newer, non-invasive high-tech tests are available, such as virtual colonoscopy and CT colonography, however, these radiological exams still require colon-cleansing preparations and cannot remove any polyps that are found.

* In the future, simple blood tests that can detect molecular markers for colon cancer will be available. Grady is a leading researcher in this area. Developing an effective blood test is important because it will greatly increase the rate of screening.

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SOURCE Fred Hutchinson Cancer Research Center
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