However, you may need to be tested earlier than 45, or more often than other people, if—. If you think you are at increased risk for colorectal cancer, speak with your doctor about—. Most insurance plans and Medicare help pay for colorectal cancer screening for people who are 50 years old or older. Colorectal cancer screening tests may be covered by your health insurance policy without a deductible or co-pay.
For more information about Medicare coverage, visit www. TTY users should call 1 Check with your insurance plan to find out what benefits are covered for colorectal cancer screening.
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Who is at risk for colorectal cancer? What methods are used to screen people for colorectal cancer? Does health insurance pay for colorectal cancer screening? What happens if a colorectal cancer screening test finds an abnormality? What new tests are being developed for colorectal cancer screening?
What is colorectal cancer? Both polyps and colorectal cancers can bleed, and stool tests check for tiny amounts of blood in feces stool that cannot be seen visually.
Blood in stool may also indicate the presence of conditions that are not cancer, such as hemorrhoids. With these tests, stool samples are collected by the patient using a kit, and the samples are returned to the doctor. People who have a positive finding with these tests are advised to have a colonoscopy. Because gFOBT can also detect heme in some foods for example, red meat , people must avoid certain foods before having this test. FIT uses antibodies to detect hemoglobin protein specifically 5 , 6.
Dietary restrictions are typically not required for FIT. The DNA comes from cells in the lining of the colon and rectum that are shed and collect in stool as it passes through the large intestine and rectum.
Randomized trials have shown that gFOBT, when performed every 1 to 2 years in people aged 50 to 80 years, can help reduce the number of deaths due to colorectal cancer 7 , 8. If gFOBT or FIT is the only type of colorectal cancer screening test performed, experts generally recommend testing every year or two In one study of people who were at average risk of developing colon cancer and had no symptoms of colon problems 11 , the FIT-DNA test was more sensitive than the FIT test.
However, the FIT-DNA test also was more likely to identify an abnormality when none was actually present that is, it had more false-positive results, which can lead to unnecessary colonoscopies. In this test, the rectum and sigmoid colon are examined using a sigmoidoscope, a flexible lighted tube with a lens for viewing and a tool for removing tissue.
This instrument is inserted through the anus into the rectum and sigmoid colon as air is pumped into the colon to expand it so the doctor can see the colon lining more clearly. During sigmoidoscopy, abnormal growths in the rectum and sigmoid colon can be removed for analysis biopsied. The lower colon must be cleared of stool before sigmoidoscopy, but the preparation is not very extensive. People are usually not sedated for this test. Clinical trials have shown that having sigmoidoscopy lowers the risks of developing and dying from colorectal cancer 12 — Experts generally recommend sigmoidoscopy every 5 or 10 years for people at average risk who have had a negative test result These tests each have different risks and benefits see the table below , and some of them might be better options for you than others.
If you choose to be screened with a test other than colonoscopy, any abnormal test result should be followed up with a timely colonoscopy. Some of these tests might also be used if you have symptoms of colorectal cancer or other digestive diseases such as inflammatory bowel disease. These tests look at the stool feces for possible signs of colorectal cancer or polyps.
These tests are typically done at home, so many people find them easier than tests like a colonoscopy. But these tests need to be done more often. And if the result from one of these stool tests is positive abnormal , you will still need a colonoscopy to see if you have cancer.
One way to test for colorectal cancer is to look for occult hidden blood in the stool. The idea behind this type of test is that blood vessels in larger colorectal polyps or cancers are often fragile and easily damaged by the passage of stool.
The damaged vessels usually bleed into the colon or rectum, but only rarely is there enough bleeding for blood to be seen by the naked eye in the stool. The fecal immunochemical test FIT checks for hidden blood in the stool from the lower intestines. This test must be done every year, unlike some other tests like the visual tests described below. It can be done in the privacy of your own home. Unlike the gFOBT see below , there are no drug or dietary restrictions before the FIT test because vitamins and foods do not affect the test , and collecting the samples may be easier.
This test is also less likely to react to bleeding from the upper parts of the digestive tract, such as the stomach. Collecting the samples: Your health care provider will give you the supplies you need for testing. Have all of your supplies ready and in one place. Supplies typically include a test kit, test cards or tubes, long brushes or other collecting devices, waste bags, and a mailing envelope.
The kit will give you detailed instructions on how to collect the samples. Be sure to follow the instructions that come with your kit, as different kits might have different instructions.
Once you have collected the samples, return them as instructed in the kit. If the test result is positive that is, if hidden blood is found , a colonoscopy will need to be done to investigate further.
Although blood in the stool can be from cancer or polyps, it can also be from other causes, such as ulcers, hemorrhoids, or other conditions. The guaiac-based fecal occult blood test gFOBT finds occult hidden blood in the stool through a chemical reaction.
This test can be done in the privacy of your own home. It checks more than one stool sample. If gFOBT is chosen for colorectal screening, the American Cancer Society recommends the highly sensitive versions of this test be used.
Before the test: Some foods or drugs can affect the results of this test, so you may be instructed to avoid the following before this test:. Even if you are concerned that something you ate may alter the test, the most important thing is to get the test done.
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