Prevention and Early Diagnosis of Colorectal Cancer

What is screening for colorectal cancer?
Screening for colorectal cancer is a series of easily performed tests used to find polyps or early cancers of the colon and rectum.

Why do we screen colorectal cancer?
Most colorectal cancers begin as benign tumors called polyps. Most polyps cause no symptoms and take five to seven years to change to cancer. If polyps are found early, they usually can be removed by an out-patient procedure that does not involve surgery. Medical research tells us that most colorectal cancers can be prevented if polyps are found and removed.

What are the screening recommendations?
We use the recommendations of the American Cancer Society. They are as follows:
**A rectal examination every year after age forty.
**A stool for invisible blood every year after age fifty.
**A flexible sigmoidoscopy every five years after age fifty.
**A colonoscopy every 10 years after age 50.
These guidelines only apply to people who have no symptoms. If there is rectal bleeding, change in bowel habits, personal or family histories of polyps or colorectal cancer, history of inflammatory bowel disease, or personal history of uterine, or ovarian cancer, discuss these factors with your physician.

What is the stool test for blood?
This test checks stool samples for blood that cannot be seen with the naked eye. This is a test that can be done easily at home and sent to the laboratory for processing. An abnormal test usually indicates bleeding in the intestinal tract. It may signal the presence of polyps or early colorectal cancer. Most polyps do not bleed. Therefore, this test alone is not an adequate screening test.

What is flexible sigmoidoscopy?
Flexible sigmoidoscopy is the examination of the lower one-third to one-half of the colon. It is a procedure done in the office using a flexible tube about the thickness of one’s little finger. The areas seen with this test are where most polyps occur. A rectal exam is done at the time of the procedure. A screening sigmoidoscopy is done only if stool testing is negative for blood and there is no history of colon problems mentioned earlier.

What is a colonoscopy?
A colonoscopy is like a flexible sigmoidoscopy except the scope is about twice as long to allow examination of the entire colon and even the last part of the small intestine, most of the time. This test is normally done with some sedation as the increased turns required to advance the scope through the
entire colon increases the discomfort.

Does insurance cover the cost of these procedures?
Since the stool test for blood and flexible sigmoidoscopy are considered "screening" procedures, many insurances may not cover the cost. Please check with your own insurance provider regarding your coverage. As of January 1, 1998, Medicare does cover the cost of both the stool test for blood and the sigmoidoscopy. Also, beginning July 1, 2001, Medicare covers screening colonoscopy in patients over 50. Our business office will answer any questions you have regarding costs of these procedures. If you decide to participate in this screening program or have any questions, please contact your personal physician or nurse at Dubuque Internal Medicine. You may also contact the G.I. Nurse Clinical Coordinator at 563-557-9111.                      

A message to all Patients:
Colorectal cancer is one of the leading causes of cancer death in the United States. Because of this, we have made early detection of colorectal cancer a priority. Colorectal cancer can be prevented. Unlike some forms of cancer, it can be cured if detected early. Please read this
information and call the office with any questions.

The Physicians and Staff at Dubuque Internal Medicine                                                

1. Limit of digital 2. Limit of rigid proctoscope 3. Limit of (75 cm) flexible sigmoidoscope 4. Limit of stool for occult blood and colonoscopy