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Colorectal Cancer Screening

Colorectal cancer screening should begin at age 50 for individuals of average risk, and earlier for individuals who have been identified as having an increased risk. Patients at an increased risk of developing cancer include those with inflammatory bowel disease, those with certain genetic syndromes, and those with a family history of colon cancer.

Several methods are available for colorectal cancer screening and a decision on the best approach for an individual should be made with the guidance of a physician. Routine testing can be lifesaving, as it can lead to cancer prevention.

Colorectal Screening
Colorectal cancer screening is important for early detection and cancer prevention.

Types of colorectal cancer screening tests

Endoscopic and radiologic examinations:

  • Colonoscopy (recommended) – After a patient is sedated, a flexible tube (colonoscope) with a tiny camera attached to the tip is inserted into the rectum, enabling a physician to view the interior of the entire colon and rectum on an external monitor to detect polyps and other potential abnormalities. If necessary, a physician can pass special instruments through the colonoscope to remove polyps or obtain tissue samples for biopsy.
  • CT colonography (CTC, formerly referred to as "virtual colonoscopy") – A series of computerized tomography (CT) scans are taken of a patient’s colon after a small tube (catheter) is inserted into the rectum and used to fill the colon with air to improve image quality. A physician will then review the images to check for signs of colorectal cancer.
  • Flexible sigmoidoscopy; can be combined with FIT or sensitive gFOBT – A flexible tube (sigmoidoscope) with a small camera attached to the end is inserted into a patient’s rectum, allowing a physician to view the interior of the rectum and lower half of the colon. If small polyps are detected, the physician may remove them during the procedure for further testing. If cancer is suspected, a follow-up colonoscopy may be recommended.

Stool-based tests:

  • Guaiac-based fecal occult blood test (gFOBT) – The more sensitive gFOBT test should be used, if this method is chosen.
  • Fecal immunochemical test (FIT) – The quantitative test should be performed when available; may use the qualitative test if quantitative tests are not available.
  • FIT-DNA (multitargeted stool DNA test, combining fecal DNA, FIT, and DNA methylation assays) – Cologuard assay available in the United States.

Because colon cancer is one of the only cancers that can be easily and reliably detected in people who do not have symptoms, Moffitt Cancer Center encourages individuals to stay up-to-date with their screenings. If you’d like to speak with a physician about screening for colorectal cancer, call 1-888-663-3488 or complete a new patient registration form online. No referrals are required.