Screening and Diagnosis

All average-risk adults aged 50 years or older should undergo one or

more of the following: annual Fecal occult blood test, flexible
sigmoidoscopy every 5 years, double-contrast barium enema (DCBE)
every 5 years, CT colonography every 5 years, or Colonoscopy every
10 years. All positive tests should be followed up with a colonoscopy.
High-risk patients, including those with a personal or family history of
colorectal cancer or polyps, or a history of inflammatory bowel disease,
Should be screened earlier and more frequently.
Adults with signs or symptoms consistent with colorectal neoplasm
should undergo testing to exclude the presence of a mass.

Genetic Counseling
Individuals who are identified as at risk can be offered counseling on the
genetics of hereditary cancer, genetic testing options and risk reduction.
Indications for a colon/uterine cancer genetics evaluation include:
Individuals who have two close relatives with colon and/or uterine
cancer at any age.
Individuals who have been diagnosed with polyposis ( > 10 polyps
found in the colon) or close relatives of an individual diagnosed with
polyposis.
Individuals who have had colon or uterine cancer prior to age 50.
Individuals who have had two separate colon cancers or both colon and
uterine cancer at any age.

Fecal Occult Blood Test

A microscopic examination of feces is checked for blood.

Digital Rectal Exam

A physical examination of the inside of the rectum to feel for lumps or any
unusual masses.

Barium Enema
A series of X-rays of the lower gastrointestinal tract taken after barium is put
into the rectum to coat the gastrointestinal tract.

Sigmoidoscopy
An examination of the rectum and lower colon with a lighted fiber-optic tube
inserted through the anus. In addition to looking for polyps, abnormal areas
or cancer, the sigmoidoscope can often take samples of suspicious areas for
biopsy.

Colonoscopy
An examination of the rectum and entire colon with a flexible lighted fiberoptic tube inserted through the anus. The colonoscope's is long enough to
examine the entire colon. Like a sigmoidoscope, a colonoscope can take

samples of suspicious areas for biopsy in addition to looking for polyps,

abnormal areas or cancer. A biopsy is required to diagnose colorectal cancer.