Screening tests play a key role in detecting polyps before they become cancerous. These tests can also help discover colorectal cancer in its early stages, when the chance of recovery is best. Several screening methods exist, each with its own benefits and risks. Be sure to discuss these with your doctor before choosing a screening test.
If you suspect that you are experiencing colon polyps, you can start the diagnostic process by first seeing your family doctor or a general practitioner. However, in some cases when you call to set up an appointment, you may be referred immediately to a gastroenterologist. Your doctor is likely to ask you a number of questions. Be ready to answer the following question reserve time to go over points you want to spend more time on. Your doctor may ask:
The doctor can use one or more tests to check for colon polyps. Your doctor might begin a physical exam taking a careful abdominal exam followed by a rectal exam. Be advised that the discovery of one polyp necessitates a complete colon inspection, since at least 30 percent of these patients will have additional polyps. Other diagnostic exams include:
Barium enema - During this procedure, doctors insert a liquid called barium into the rectum before taking x rays of the large intestine. Barium makes your intestine look white in the pictures. Polyps are dark, so they’re easy to see. This procedure doesn't allow your doctor to take a biopsy during the procedure to determine whether a polyp is cancerous.
Colonoscopy - During a colonoscopy, a doctor views the entire large intestine with a long, flexible tube via a camera that shows images on a TV screen. If any polyps are found during the exam, your doctor may remove them immediately or take tissue samples (biopsies) for analysis. To prepare for the exam, doctors suggest diet restriction and laxatives to cleanse your bowel.
Computerized tomography (CT) scan – During a CT scan, the doctor inserts a thin, flexible tube into the rectum. A machine using x rays and computers creates pictures of the large intestine that can be seen on a screen. If a CT scan discovers polyps, they can be removed during a colonoscopy.
Fecal occult (hidden) blood test - This noninvasive test checks a sample of stool for blood and other signs of cancer, such as dna changes. Although this test is relatively easy, it's designed to screen for cancer, not for polyps. One problem is that most polyps don't bleed, nor do all cancers. Likewise, if blood shows up in stool, it may be the result of hemorrhoids or an intestinal condition other than cancer. For these reasons, doctors may recommend other screening methods instead of, or in addition to, fecal occult blood tests. Also, even if the test is negative, if you have seen blood in the toilet, toilet paper or stool, you will need to go through further testing.
Flexible sigmoidoscopy - During this procedure, a doctor uses a slender, lit tube to examine the rectum and sigmoid (the last 2 feet of the colon) but doesn't detect polyps elsewhere in the large intestine. It's often combined with a barium enema to better visualize the entire colon, or your doctor may recommend performing a colonoscopy instead.
Genetic testing - If you have a family history of colorectal cancer, you may be a candidate for genetic testing. A blood test may help determine if you're at increased risk of colon or rectal cancer. Knowing you have a genetic predisposition can alert you to the need for regular screening.
Lower gastrointestinal (GI) series - A lower GI series uses a barium enema and x rays to diagnose problems in the large intestine, which includes the colon and rectum. This test may help discover problems such as abnormal growths, ulcers, polyps, diverticuli, and colon cancer.
Once colon polyps have been diagnosed, you can begin treatment, which is based on prevention and removal of polyps. To learn about the most common forms of treatment for different types of colon polyps, read the Treating Colon Polyps section that follows for more information.
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