Colon cancer is a disease in which cancer cells form in the tissues of the colon, the longest part of the large intestine. Learn about symptoms, risk factors, tests, and treatments.
Polyp Embedded in Colon
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General Info
Tumor Growth
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Tumor Growth
Two types of growth occur in the colon:
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What Is Colon Cancer?
Colon cancer is a disease in which malignant (cancer) cells form in the tissues of the colon.
The colon is part of the body’s digestive system. The digestive system removes and processes nutrients (vitamins, minerals, carbohydrates, fats, proteins, and water) from foods and helps pass waste material out of the body. The digestive system is made up of the esophagus, stomach, and the small and large intestines. The colon (large bowel) is the main part of the large intestine and is about 5 feet long. Together, the rectum and anal canal make up the last part of the large intestine and are about 6-8 inches long. The anal canal ends at the anus (the opening of the large intestine to the outside of the body).
Anatomy of the lower digestive system, showing the colon and other organs.
Gastrointestinal stromal tumors can occur in the colon.
Source: National Cancer Institute (NCI)
Additional Materials (15)
Who's at risk for colon cancer? - Amit H. Sachdev and Frank G. Gress
Video by TED-Ed/YouTube
The Colon and Colon Cancer
Video by Armando Hasudungan/YouTube
What is a flexible sigmoidoscopy?
Video by You and Colonoscopy/YouTube
Dr. Jonathan Leighton: New guidelines lower colon cancer screening to age 45
Video by Mayo Clinic/YouTube
Colon or rectal cancer diagnosis: should I get a second opinion?
Video by Swedish/YouTube
Take Control Over Colon Cancer
Video by Hopkins Kimmel/YouTube
What are polyps in the colon?
Video by UAMS/YouTube
Diagnosing colon cancer
Video by Top Doctors UK/YouTube
What's the best diet strategy to prevent colon cancer
Video by Mayo Clinic/YouTube
Colorectal Cancer Screening: Colonoscopy Saves Lives
Video by Roswell Park Comprehensive Cancer Center/YouTube
What Percentage of Colon Polyps are Cancerous? • Precancerous Polyps | Los Angeles Surgery
Video by La Peer/YouTube
Colorectal Cancer Screening
Video by Mechanisms in Medicine/YouTube
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
Video by University of California Television (UCTV)/YouTube
Colon Cancer: Risk Factors & Screening
Video by University Hospitals/YouTube
What is Colorectal Cancer?
Video by Stanford Health Care/YouTube
4:44
Who's at risk for colon cancer? - Amit H. Sachdev and Frank G. Gress
TED-Ed/YouTube
10:05
The Colon and Colon Cancer
Armando Hasudungan/YouTube
1:55
What is a flexible sigmoidoscopy?
You and Colonoscopy/YouTube
4:05
Dr. Jonathan Leighton: New guidelines lower colon cancer screening to age 45
Mayo Clinic/YouTube
2:40
Colon or rectal cancer diagnosis: should I get a second opinion?
Swedish/YouTube
1:01
Take Control Over Colon Cancer
Hopkins Kimmel/YouTube
4:01
What are polyps in the colon?
UAMS/YouTube
5:17
Diagnosing colon cancer
Top Doctors UK/YouTube
0:52
What's the best diet strategy to prevent colon cancer
Mayo Clinic/YouTube
1:14
Colorectal Cancer Screening: Colonoscopy Saves Lives
Roswell Park Comprehensive Cancer Center/YouTube
2:23
What Percentage of Colon Polyps are Cancerous? • Precancerous Polyps | Los Angeles Surgery
La Peer/YouTube
2:42
Colorectal Cancer Screening
Mechanisms in Medicine/YouTube
1:26:06
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
University of California Television (UCTV)/YouTube
3:42
Colon Cancer: Risk Factors & Screening
University Hospitals/YouTube
3:47
What is Colorectal Cancer?
Stanford Health Care/YouTube
Risk Factors
Obesity and Colon Cancer - Cross Section of African American male abdomen exposing extracorporeal fat and toxic visceral fat
Image by TheVisualMD
Obesity and Colon Cancer - Cross Section of African American male abdomen exposing extracorporeal fat and toxic visceral fat
Image by TheVisualMD
What Are the Risk Factors for Colon Cancer?
Health history affects the risk of developing colon cancer.
Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk to your doctor if you think you may be at risk for colorectal cancer.
Risk factors for colorectal cancer include the following:
Having a family history of colon or rectal cancer in a first-degree relative (parent, sibling, or child).
Having a personal history of cancer of the colon, rectum, or ovary.
Having a personal history of high-risk adenomas (colorectal polyps that are 1 centimeter or larger in size or that have cells that look abnormal under a microscope).
Having inherited changes in certain genes that increase the risk of familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary nonpolyposis colorectal cancer).
Having a personal history of chronic ulcerative colitis or Crohn disease for 8 years or more.
Having three or more alcoholic drinks per day.
Smoking cigarettes.
Being Black.
Being obese.
Older age is a main risk factor for most cancers. The chance of getting cancer increases as you get older.
Who's at risk for colon cancer? - Amit H. Sachdev and Frank G. Gress
TED-Ed/YouTube
3:42
Colon Cancer: Risk Factors & Screening
University Hospitals/YouTube
2:59
What Is Your Genetic Risk for Colon Cancer?
Stanford Health Care/YouTube
25:46
Colon Cancer: Risk, Prevention, and Screening | Fola May, MD, PhD, MPhil | UCLAMDChat
UCLA Health/YouTube
14:27
Risk Factors for Colorectal Cancer
Columbia University Department of Surgery/YouTube
Signs
Signs & Symptoms
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Signs & Symptoms
Unfortunately, colorectal cancer is often asymptomatic (without symptoms) in its early stages Symptoms may appear only when the cancer has reached an advanced stage and the cancer is more difficult to treat. When symptoms do appear, they vary according to the size of the cancer and its location in the colon or rectum.
Image by TheVisualMD
What Are Signs and Symptoms of Colon Cancer?
These and other signs and symptoms may be caused by colon cancer or by other conditions. Check with your doctor if you have any of the following:
A change in bowel habits.
Blood (either bright red or very dark) in the stool.
Diarrhea, constipation, or feeling that the bowel does not empty all the way.
Stools that are narrower than usual.
Frequent gas pains, bloating, fullness, or cramps.
Weight loss for no known reason.
Feeling very tired.
Vomiting.
Source: National Cancer Institute (NCI)
Additional Materials (8)
Symptoms of bowel cancer
Video by Cancer Research UK/YouTube
Colon Cancer Symptoms & Treatments
Video by Bowel Cancer Australia/YouTube
Signs and Symptoms of Colon and Rectal Cancer | Dana-Farber Cancer Institute
Video by Dana-Farber Cancer Institute/YouTube
Colon Cancer: Don't Ignore Your Symptoms
Video by American Cancer Society/YouTube
Are the Symptoms the Same for Colon, Rectal, and Anal Cancer?
Video by HCA West Florida/YouTube
Cancer signs and symptoms
Symptoms of Cancer : The symptoms of cancer depend on the type of cancer, its location, the size of the tumor, and how much it affects nearby organs or tissues. If a cancer has metastasized, symptoms may appear in different parts of the body. Some cancers may be asymptomatic (have no symptoms at all) or be asymptomatic until the cancer has reached an advanced stage. Pancreatic cancer, for example, may not cause symptoms until the cancerous cells have grown around nearby nerves. Symptoms that are commonly seen with different forms of cancer include chills, fever, malaise, night sweats, unexplained weight loss, pain, loss of appetite, and change in bowel habits or bladder function.
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Colorectal Polyps, Causes, Signs and Symptoms, Diagnosis and Treatment.
Virtual colonoscopy is a new technology that uses computerized tomography (CT) images to look for polyps and cancer in the colon. The result is a computer-generated, animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy is performed for removal or biopsy of the growth.
Interactive by TheVisualMD
Which Tests Are Used to Diagnose Colon Cancer?
The following tests and procedures may be used:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Digital rectal exam: An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum to feel for lumps or anything else that seems unusual.
Fecal occult blood test (FOBT): A test to check stool (solid waste) for blood that can only be seen with a microscope. A small sample of stool is placed on a special card or in a special container and returned to the doctor or laboratory for testing. Blood in the stool may be a sign of polyps, cancer, or other conditions. There are two types of FOBTs:
Guaiac FOBT: The sample of stool on the special card is tested with a chemical. If there is blood in the stool, the special card changes color.A guaiac fecal occult blood test (FOBT) checks for occult (hidden) blood in the stool. Small samples of stool are placed on a special card and returned to a doctor or laboratory for testing.
Immunochemical FOBT: A liquid is added to the stool sample. This mixture is injected into a machine that contains antibodies that can detect blood in the stool. If there is blood in the stool, a line appears in a window in the machine. This test is also called fecal immunochemical test or FIT.A fecal immunochemical test (FIT) checks for occult (hidden) blood in the stool. A small sample of stool is placed in a special collection tube or on special cards and returned to a doctor or laboratory for testing.
Barium enema: A series of x-rays of the lower gastrointestinal tract. A liquid that contains barium (a silver-white metallic compound) is put into the rectum. The barium coats the lower gastrointestinal tract and x-rays are taken. This procedure is also called a lower GI series.Barium enema procedure. The patient lies on an x-ray table. Barium liquid is put into the rectum and flows through the colon. X-rays are taken to look for abnormal areas.
Sigmoidoscopy: A procedure to look inside the rectum and sigmoid (lower) colon for polyps (small areas of bulging tissue), other abnormal areas, or cancer. A sigmoidoscope is inserted through the rectum into the sigmoid colon. A sigmoidoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.Sigmoidoscopy. A thin, lighted tube is inserted through the anus and rectum and into the lower part of the colon to look for abnormal areas.
Colonoscopy: A procedure to look inside the rectum and colon for polyps, abnormal areas, or cancer. A colonoscope is inserted through the rectum into the colon. A colonoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer.Colonoscopy. A thin, lighted tube is inserted through the anus and rectum and into the colon to look for abnormal areas.
Virtual colonoscopy: A procedure that uses a series of x-rays called computed tomography to make a series of pictures of the colon. A computer puts the pictures together to create detailed images that may show polyps and anything else that seems unusual on the inside surface of the colon. This test is also called colonography or CT colonography.
Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.
Source: National Cancer Institute (NCI)
Additional Materials (49)
45+? It may be time to start self-screening your poop
Colorectal Cancer Spread Into Colon Stage 2 : Cancer spreads in three ways: by invading surrounding tissue, by invading the lymph system and traveling through lymph vessels to other places in the body, and by invading veins and capillaries and traveling through the bloodstream to other places in the body. Stage II: Cancer has spread beyond the colon's middle layers and possibly into nearby tissues or organs, but hasn't spread to lymph nodes.
Image by StoryMD
Screening & Diagnosis
Image by TheVisualMD
Screening and Diagnosis Fecal Occult Blood Test
A fecal occult blood test (FOBT) finds blood in the stool by placing a stool sample on a chemically treated card, pad, or cloth wipe. A fecal occult blood test may be used to check for colorectal cancer, but it is never used to diagnose the condition.
Image by TheVisualMD
Cologuard® Test Kit
Cologuard analyzes both DNA alterations and blood in the stool to detect the presence of colon cancer and precancers. With Cologuard, patients can provide a sample in the privacy of their own home.
Image by Exact Sciences
Colorectal Cancer Screening: When, How, and Who?
With its Screen to Save initiative, the National Cancer Institute's Center to Reduce Cancer Health Disparities aims to increase colorectal cancer screening rates among men and women age 50 and older from racially and ethnically diverse communities and in rural areas.
Image by National Cancer Institute (NCI)
Cancer screening
Cancer Imaging : Imaging is used before, during, and after cancer treatment. Screening using imaging can help determine if there are abnormal areas present that may be cancerous. Imaging can be used in diagnosis and staging to find out how much cancer is in the body, where it`s located, and if it`s metastasized. During treatment, imaging can determine the exact tumor location and show if a treatment is working by showing if a tumor is shrinking or has changed. After treatment, imaging can be used to see if a cancer has recurred or metastasized elsewhere. Types of imaging used include X-rays, ultrasound, magnetic resonance imaging (MRI), computerized tomography (CT), positron emission tomography (PET), PET/CT, and single photon emission computerized tomography (SPECT).
Image by TheVisualMD
A Less Invasive Look
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Image by TheVisualMD
Screening and Diagnosis Colonoscope
A colonoscopy is an examination of the interior of the colon. It is often used as a screening tool for early detection of colorectal cancer. During a colonoscopy, a long flexible tube with a video camera at one end, called a colonoscope, is inserted first into the anus and then into the colon. The doctor can view the inside of the colon along its entire length on a video monitor.
Image by TheVisualMD
Diagram showing sigmoidoscopy
Diagram showing sigmoidoscopy
Image by Cancer Research UK
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Diagram showing a colonoscopy
Diagram showing a colonoscopy.
Image by Cancer Research UK / Wikimedia Commons
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X-ray computed tomography - CT Slices of the Abdomen
CT Scan - CT Slices of the Abdomen
Interactive by TheVisualMD
PET/CT
CT
PET
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PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
PET scans can often detect a tumor that can't be seen on CT scans or regular X-rays. Cancer tumors grow rapidly and so actively metabolize glucose. In a PET scan, the patient is injected with glucose containing a radioactive tracer. The PET scan image shows areas of the body that utilize the glucose. The brain, heart, and bladder all metabolize glucose and appear black in the image, along with any cancer tumors that are present.
Interactive by TheVisualMD
What happens during and after a colonoscopy?
Video by You and Colonoscopy/YouTube
Colonoscopy and Flexible Sigmoidoscopy
Video by Gastro Pros/YouTube
What are Colonoscopy Risks? • Risks of Colonoscopy | Colonoscopy Center of Excellence
Video by La Peer/YouTube
What is a colonoscopy and how do I prepare for it?
Video by You and Colonoscopy/YouTube
Why No One Should Be Afraid of a Colonoscopy
Video by Stanford Health Care/YouTube
Colorectal Cancer Screening: Colonoscopy Saves Lives
Video by Roswell Park Comprehensive Cancer Center/YouTube
What to expect during a colonoscopy
Video by MD Anderson Cancer Center/YouTube
Preparing for a Colonoscopy
Video by Dartmouth-Hitchcock/YouTube
Having a colonoscopy
Video by Cancer Research UK/YouTube
Miriam Margolyes - My Colonoscopy Experience
Video by Bowel Cancer Australia/YouTube
What happens during a colonoscopy?
Video by NHS/YouTube
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
Video by University of California Television (UCTV)/YouTube
Video by PreOp.com Patient Engagement - Patient Education/YouTube
UCSF Radiology: How is Virtual Colonoscopy Performed?
Video by UCSF Imaging/YouTube
Virtual Colonoscopy - Lexington Diagnostic Center
Video by Lexington Diagnostic Center/YouTube
Virtual Colonoscopy-Mayo Clinic
Video by Mayo Clinic/YouTube
How to prepare for a colonoscopy
Video by MD Anderson Cancer Center/YouTube
5 Things to Know About Colonoscopy - The Nebraska Medical Center
Video by Nebraska Medicine Nebraska Medical Center/YouTube
What is a flexible sigmoidoscopy?
Video by You and Colonoscopy/YouTube
Digestive health: Successful prep for colonoscopy
Video by UW Medicine/YouTube
Colonoscopy: Why Routine Screenings Are Important
Video by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)/YouTube
Colonoscopy: A Journey Though the Colon and Removal of Polyps
Video by AmCollege Gastro/YouTube
Preparing for a colonoscopy
Video by AmerGastroAssn/YouTube
Colorectal Cancer Screening
Video by Mechanisms in Medicine/YouTube
Screening for Colorectal Cancer
Video by Dartmouth-Hitchcock/YouTube
3D Medical Animation, NHS Bowel Cancer Screening ( physician's module 3 )
Video by ASKVisualScience/YouTube
Testing for bowel cancer
Video by Cancer Research UK/YouTube
NHS Bowel Cancer Screening Module 2
Video by AS&K Communications - Visual Science/YouTube
Colon Cancer: Don't Ignore Your Symptoms
Video by American Cancer Society/YouTube
NHS Bowel Cancer Screening Module 4
Video by AS&K Communications - Visual Science/YouTube
NHS Bowel Cancer Screening - It's Your Choice | part 1
Video by CreationVideo | Video Production + Live Streaming/YouTube
Colonoscopy with arrows showing direction
A colonoscopy is an examination of the interior of the colon. It is often used as a screening tool for early detection of colorectal cancer. During a colonoscopy, a long flexible tube with a video camera at one end, called a colonoscope, is inserted first into the anus and then into the colon. The doctor can view the inside of the colon along its entire length on a video monitor.
Image by TheVisualMD
Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations Breast cancer
Mammography: Women 40 and older should have a mammogram every year.
Clinical breast exam (breast exam performed by a medical professional): Women age 20-40 should have one every 3 years. Women 40 and older should have one every year.
Breast self-exam: Women age 20 and older should perform one each month (considered optional).
If you have a family history of breast cancer, talk to your healthcare professional about what type of screening you should have, and how often.
Image by TheVisualMD
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Sigmoidoscopy: NCI B-roll [video]
NCI B-roll of a patient receiving a sigmoidoscopy. This video is silent. A version of this video with audio can be found in the video NCI Detection B-roll. Downloadable video files are 1280x720 at 30 fps. This image is part of the NCI B-Roll Videos collection.
View video using embedded player on this page or at youtube.com.
Video by National Cancer Institute (NCI)
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Cancer Detection: NCI B-Roll [video]
Includes footage of mammography, digital mammography, Magnetic Resonance Imaging (MRI), palpation, sigmoidoscopy, digital rectal exam (DRE), chest X-ray, spiral CT, and pap test.
Video by National Cancer Institute (NCI)
45+? It may be time to start self-screening your poop
StoryMD
Screening & Diagnosis
TheVisualMD
Screening and Diagnosis Fecal Occult Blood Test
TheVisualMD
Cologuard® Test Kit
Exact Sciences
Colorectal Cancer Screening: When, How, and Who?
National Cancer Institute (NCI)
Cancer screening
TheVisualMD
A Less Invasive Look
TheVisualMD
Screening and Diagnosis Colonoscope
TheVisualMD
Diagram showing sigmoidoscopy
Cancer Research UK
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Cancer Research UK / Wikimedia Commons
X-ray computed tomography - CT Slices of the Abdomen
TheVisualMD
PET/CT Scans of Colorectal Cancer 1) Pet/CT scan 2) CT Scan 3) Pet Scan
TheVisualMD
5:15
What happens during and after a colonoscopy?
You and Colonoscopy/YouTube
2:49
Colonoscopy and Flexible Sigmoidoscopy
Gastro Pros/YouTube
2:56
What are Colonoscopy Risks? • Risks of Colonoscopy | Colonoscopy Center of Excellence
La Peer/YouTube
6:30
What is a colonoscopy and how do I prepare for it?
You and Colonoscopy/YouTube
3:35
Why No One Should Be Afraid of a Colonoscopy
Stanford Health Care/YouTube
1:14
Colorectal Cancer Screening: Colonoscopy Saves Lives
Roswell Park Comprehensive Cancer Center/YouTube
1:16
What to expect during a colonoscopy
MD Anderson Cancer Center/YouTube
14:55
Preparing for a Colonoscopy
Dartmouth-Hitchcock/YouTube
1:37
Having a colonoscopy
Cancer Research UK/YouTube
0:45
Miriam Margolyes - My Colonoscopy Experience
Bowel Cancer Australia/YouTube
2:20
What happens during a colonoscopy?
NHS/YouTube
1:26:06
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
University of California Television (UCTV)/YouTube
UCSF Radiology: How is Virtual Colonoscopy Performed?
UCSF Imaging/YouTube
2:24
Virtual Colonoscopy - Lexington Diagnostic Center
Lexington Diagnostic Center/YouTube
2:19
Virtual Colonoscopy-Mayo Clinic
Mayo Clinic/YouTube
8:08
How to prepare for a colonoscopy
MD Anderson Cancer Center/YouTube
4:18
5 Things to Know About Colonoscopy - The Nebraska Medical Center
Nebraska Medicine Nebraska Medical Center/YouTube
1:55
What is a flexible sigmoidoscopy?
You and Colonoscopy/YouTube
18:20
Digestive health: Successful prep for colonoscopy
UW Medicine/YouTube
1:11
Colonoscopy: Why Routine Screenings Are Important
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)/YouTube
3:48
Colonoscopy: A Journey Though the Colon and Removal of Polyps
AmCollege Gastro/YouTube
1:15
Preparing for a colonoscopy
AmerGastroAssn/YouTube
2:42
Colorectal Cancer Screening
Mechanisms in Medicine/YouTube
4:06
Screening for Colorectal Cancer
Dartmouth-Hitchcock/YouTube
1:40
3D Medical Animation, NHS Bowel Cancer Screening ( physician's module 3 )
ASKVisualScience/YouTube
1:37
Testing for bowel cancer
Cancer Research UK/YouTube
0:41
NHS Bowel Cancer Screening Module 2
AS&K Communications - Visual Science/YouTube
6:06
Colon Cancer: Don't Ignore Your Symptoms
American Cancer Society/YouTube
1:19
NHS Bowel Cancer Screening Module 4
AS&K Communications - Visual Science/YouTube
6:50
NHS Bowel Cancer Screening - It's Your Choice | part 1
CreationVideo | Video Production + Live Streaming/YouTube
Colonoscopy with arrows showing direction
TheVisualMD
Screening for Cancer
TheVisualMD
1:17
Sigmoidoscopy: NCI B-roll [video]
National Cancer Institute (NCI)
9:42
Cancer Detection: NCI B-Roll [video]
National Cancer Institute (NCI)
Digital Rectal Examination
Digital Rectal Examination
Also called: DRE, Digital Rectal Exam
A digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to assess your pelvic organs. It is commonly used to check the prostate gland in men, but it can also be used to evaluate the uterus and ovaries in women.
Digital Rectal Examination
Also called: DRE, Digital Rectal Exam
A digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to assess your pelvic organs. It is commonly used to check the prostate gland in men, but it can also be used to evaluate the uterus and ovaries in women.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that your doctor didn't feel any abnormalities during the exam, such as a growth or an organ enlargement.
Related conditions
Digital rectal examination (DRE) is a test in which a doctor inserts a lubricated, gloved finger into your rectum to search for certain abnormalities in the pelvic organs. This test is usually performed in men to check for abnormalities in their prostate gland, but it can also be used to evaluate a woman's uterus or ovaries.
Many doctors perform a DRE as part of a routine physical exam for men age 50 or older, some even at age 40, whether or not the man has urinary problems.
Your doctor may want to perform this test in the following situations:
If you are bleeding through your rectum
If you have pelvic pain
If you have recently had an unexplained change in your bowel habits
To collect a stool sample to check for occult (hidden) blood; this is usually done as part of the screening for rectal or colon cancer
If you are a man who has symptoms of enlarged prostate or prostate infection
Routinely to check for the size of the prostate and to look for bumps or other prostate abnormalities in men over 50 years old
First, you will need to undress below the waist; then, your doctor will ask you to lie on your side with your knees bent towards your chest, as this is the easiest and comfortable position for the test to be done. In some cases, men can also be examined while bending over the exam table; and women can also be examined during a pelvic exam, with their feet raised and placed on stirrups.
Then, the doctor will slide a lubricated, gloved finger in your rectum. At this point, he or she may want to press your abdomen with their free hand to help them feel any masses or abnormalities. You may also be asked to squeeze your rectum around their finger, so they can evaluate how well your muscles are working.
If an infection is suspected, your doctor might massage the prostate during the DRE to obtain fluid to examine with a microscope. This exam is usually done first.
No special preparations are needed for a DRE. But you should tell your doctor if you have hemorrhoids or anal fissures. The DRE may make them worse.
Most people can feel a little bit uncomfortable, but the test shouldn't be painful.
Some men can feel the urge to pee when their prostate is being examined.
In very rare cases, a vasovagal response can occur. If this happens, you can have symptoms like lightheadedness, dizziness, blurred vision, nausea, sweating, and sometimes fainting.
A normal result means that your doctor did not find any abnormalities during the exam; however, this doesn’t mean that you don’t have a problem. Your doctor may want to order further testing.
If your result was abnormal, it means that your doctor found something during the test. This may happen for several reasons, such as:
Bleeding in the digestive tract
Anal fissure (small tear in the lining of the anus)
Abscess (pus collection) in the rectum or anus
Hemorrhoids (swollen veins in the rectum or anus)
Cancer of the colon or rectum
Enlargement or abnormal growths of an organ, such as the rectum, bladder, prostate in men, or cervix, uterus, or ovaries in women.
If the DRE test indicates a problem may exist, your doctor may order additional tests.
Digital rectal exam: MedlinePlus Medical Encyclopedia [accessed on Dec 21, 2018]
Prostate Tests | NIDDK [accessed on Dec 21, 2018]
https://www.nhs.uk/conditions/rectal-examination/ [accessed on Apr 17, 2019]
https://www.webmd.com/colorectal-cancer/digital-rectal-examination [accessed on Apr 17, 2019]
https://www.verywellhealth.com/the-digital-rectal-exam-2782260 [accessed on Apr 17, 2019]
https://www.verywellhealth.com/vasovagal-reflex-1945072 [accessed on Apr 17, 2019]
https://www.cancer.net/navigating-cancer-care/diagnosing-cancer/tests-and-procedures/digital-rectal-exam-dre [accessed on Sep 16, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (5)
Sensitive content
This media may include sensitive content
Digital Rectal Exam
The prostate gland is a small gland that sits below the bladder and encircles the urethra; the gland lies close to the wall of the rectum, which allows it to be felt in a digital rectal exam, or DRE, which is performed to determine the gland is enlarged.
Image by TheVisualMD
Active Surveillance & Watchful Waiting
Not all prostate cancer treatment is radical. Active surveillance and watchful waiting are two approaches to treatment that seek to avoid the often severe side effects of curative prostate treatment. They do this by actively monitoring signs and symptoms and taking action only when necessary. Active surveillance is for men with early prostate cancer who don't have symptoms. It monitors progression of cancer through PSA and DRE testing, and includes curative treatment, such as radiation therapy, if PSA levels rise rapidly. Watchful waiting is for older men who have slow-growing cancers or men with health problems that prevent them from having surgery. This approach includes regular PSA and DRE testing, and may include hormone therapy or other palliative treatment if symptoms, such as urinary retention or pain, become acute.
Image by TheVisualMD
Cross-section diagram of a digital rectal examination showing the physician's index finger inserted into the patient's rectum to feel the size and shape of the prostate
Digital rectal exam; drawing shows a side view of the male reproductive and urinary anatomy, including the prostate, rectum, and bladder; also shows a gloved and lubricated finger inserted into the rectum to feel the prostate.
Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum and feels the prostate to check for anything abnormal.
Image by National Cancer Institute / National Cancer Institute
Sensitive content
This media may include sensitive content
Digital Rectal Exam
TheVisualMD
Active Surveillance & Watchful Waiting
TheVisualMD
Cross-section diagram of a digital rectal examination showing the physician's index finger inserted into the patient's rectum to feel the size and shape of the prostate
National Cancer Institute / National Cancer Institute
Fecal Occult Blood Test
Fecal Occult Blood Test
Also called: FOBT, Stool Hemoccult, Hemoccult Test
A fecal occult blood test looks for blood in the stool. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool. Blood in stool may indicate hemorrhoids, colorectal cancer, or another condition.
Fecal Occult Blood Test
Also called: FOBT, Stool Hemoccult, Hemoccult Test
A fecal occult blood test looks for blood in the stool. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool. Blood in stool may indicate hemorrhoids, colorectal cancer, or another condition.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative test result means that there is no blood in the stool.
Related conditions
{"label":"FIT reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A negative or normal result means the test did not detect any blood in the stool. However, because cancers in the colon may not always bleed, you may need to do the test a few times to confirm that there is no blood in your stool.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"If the FIT results come back positive for blood in the stool, your doctor will want to perform other tests, usually including a colonoscopy. The FIT test does not diagnose cancer. Screening tests such as a sigmoidoscopy or colonoscopy can also help detect cancer. Both the FIT test and other screenings can catch colon cancer early, when it is easier to treat.","conditions":["Colorectal cancer","Colon polyps","Colon ulcers","Hemorrhoids"]}],"value":0.5,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative or normal result means the test did not detect any blood in the stool. However, because cancers in the colon may not always bleed, you may need to do the test a few times to confirm that there is no blood in your stool.
Related conditions
A fecal occult blood test (FOBT) looks at a sample of your stool (poop) to check for blood. Occult blood means that you can't see it with the naked eye. And fecal means that it is in your stool.
Blood in your stool means there is bleeding in the digestive tract. The bleeding may be caused by a variety of conditions, including:
Polyps, abnormal growths on the lining of the colon or rectum
Hemorrhoids, swollen veins in your anus or rectum
Diverticulosis, a condition with small pouches in the inside wall of the colon
Ulcers, sores in the lining of the digestive tract
Colitis, a type of inflammatory bowel disease
Colorectal cancer, a type of cancer that starts in the colon or rectum
Colorectal cancer is one of the most common types of cancer in the United States. A fecal occult blood test can screen for colorectal cancer to help find the disease early when treatment may be most effective.
Other names: FOBT, stool occult blood, occult blood test, Hemoccult test, guaiac smear test, gFOBT, immunochemical FOBT, iFOBT; FIT
A fecal occult blood test is commonly used as a screening test to help find colorectal cancer before you have symptoms. The test also has other uses. It may be done when there is concern about bleeding in the digestive tract from other conditions.
In certain cases, the test is used to help find the cause of anemia. And it can help tell the difference between irritable bowel syndrome (IBS), which usually doesn't cause bleeding, and inflammatory bowel disease (IBD), which is likely to cause bleeding.
But a fecal occult blood test alone cannot diagnose any condition. If your test results show blood in your stool, you will likely need other tests to diagnose the exact cause.
Your health care provider may order a fecal occult blood test if you have symptoms of a condition that could involve bleeding in your digestive tract. Or you may have the test to screen for colorectal cancer when you don't have any symptoms.
Expert medical groups strongly recommend that people get regular screening tests for colorectal cancer. Most medical groups recommend that you start screening tests at age 45 or 50 if you have an average risk of developing colorectal cancer. They recommend regular testing until at least age 75. Talk with your provider about your risk for colorectal cancer and when you should get a screening test.
A fecal occult blood test is one or several types of colorectal screening tests. Other tests include:
A stool DNA test. This test checks your stool for blood and cells with genetic changes that may be a sign of cancer.
Colonoscopy or sigmoidoscopy. Both tests use a thin tube with a camera to look inside your colon. A colonoscopy allows your provider to see your entire colon. A sigmoidoscopy shows only the lower part of your colon.
CT colonography, also called "virtual colonoscopy." For this test, you usually drink a dye before having a CT scan that uses x-rays to take detailed 3-dimensional pictures of your entire colon and rectum.
There are pros and cons of each type of test. Your provider can help you figure out which test is right for you.
Usually, your provider will give you a kit to collect samples of your stool (poop) at home. The kit will include instructions on how to do the test.
There are two main types of fecal occult blood tests:
The guaiac fecal occult blood test (gFOBT) uses a chemical (guaiac) to find blood in stool. It usually requires stool samples from two or three separate bowel movements.
The fecal immunochemical test (iFOBT or FIT) uses antibodies to find blood in stool. Research shows that FIT testing is better at finding colorectal cancers than gFOBT testing. A FIT test requires stool samples from one to three separate bowel movements, depending on the brand of the test.
Different test kits have different instructions, so it's very important to follow the specific instructions that come with your kit. The typical process for gathering a stool sample usually includes these general steps:
Collecting a bowel movement. Your kit may include a special paper to place over your toilet to catch your bowel movement. Or you may use plastic wrap or a clean, dry container. If you are doing a guaiac test, be careful not to let any urine mix in with your stool.
Taking a stool sample from the bowel movement. Your kit will include a wooden stick or applicator brush for scraping the stool sample from your bowel movement. Follow the instructions for where to gather the sample from the stool.
Preparing the stool sample. You will either smear the stool on a special test card or insert the applicator with the stool sample into a tube that came with your kit.
Labeling and sealing the sample as directed.
Repeating the test on your next bowel movement as directed if more than one sample is needed.
Returning the samples as directed. This might be mailing them or taking them to your provider's office or a lab.
You do not need any special preparations for many fecal occult blood tests. But for some guaiac fecal occult blood tests (gFOBTs), certain foods, supplements, and medicines may affect the results of the test. If you are having one of these tests, your provider will tell you what you need to avoid and for how long. For example, you might need to avoid:
Nonsteroidal, anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and aspirin. If you take aspirin for heart problems, talk with your provider before stopping your medicine. You may be able to take acetaminophen during this time but check with your provider before taking it.
Vitamin C in amounts over 250 mg a day. This includes vitamin C from supplements, fruit juices, or fruit.
Red meat, such as beef, lamb, and pork. Traces of blood from these meats may show up in your stool.
Certain raw fruits and vegetables.
There is no known risk to having a fecal occult blood test.
If your results from a fecal occult blood test show that you have blood in your stool, it means you likely have bleeding somewhere in your digestive tract. But that doesn't always mean you have cancer. Other conditions that may cause blood in your stool include ulcers, hemorrhoids, polyps, and benign (not cancer) tumors.
If you have blood in your stool, your provider will likely recommend more tests to figure out the exact location and cause of your bleeding. The most common follow-up test is a colonoscopy. If you have questions about your test results, talk with your provider.
Learn more about laboratory tests, reference ranges, and understanding results.
Regular colorectal cancer screenings, such as fecal occult blood tests, are an important tool in the fight against cancer. Studies show that screening tests can help find cancer early and may reduce deaths from the disease.
If you decide to use fecal occult blood testing for your colorectal cancer screening, you will need to do the test every year.
You can buy gFOBT and FIT stool collection kits without a prescription. Most of these tests require you to send a sample of your stool to a lab. But some tests can be done completely at home for quick results. If you're considering buying your own test, ask your provider which one is best for you.
Fecal Occult Blood Test (FOBT): MedlinePlus Lab Test Information [accessed on Dec 28, 2018]
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Dec 28, 2018]
Additional Materials (4)
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Screening & Diagnosis
Colorectal cancer includes cancer of both the colon and rectum. It is the fourth most common cancer in the United States and the second leading cause of cancer-related deaths affecting both men and women equally. The CDC recommends that everyone age 50 or over be screened. When diagnosed early, patients have a 90% 5-year survival rate.
Video by TheVisualMD
Screening and Diagnosis Fecal Occult Blood Test
A fecal occult blood test (FOBT) finds blood in the stool by placing a stool sample on a chemically treated card, pad, or cloth wipe. A fecal occult blood test may be used to check for colorectal cancer, but it is never used to diagnose the condition.
Image by TheVisualMD
Fecal impaction
Fecal impaction : Plain abdominal X-ray showing a huge fecal impaction extending from the pelvis upwards to the left subphrenic space and from the left towards the right flank, measuring over 40 cm in length and 33 cm in width.
Image by Di Saverio S, Tugnoli G, Orlandi PE, Casali M, Catena F, et al.
Colorectal Cancer Types of Surgery
TheVisualMD
4:12
Colorectal Cancer Screening & Diagnosis
TheVisualMD
Screening and Diagnosis Fecal Occult Blood Test
TheVisualMD
Fecal impaction
Di Saverio S, Tugnoli G, Orlandi PE, Casali M, Catena F, et al.
Lower GI Series
Barium Enema
Also called: Lower GI Series
A barium enema, also called a lower GI series, is an x-ray exam used to help diagnose problems of the large intestine. To make the large intestine more visible on x-ray, the intestine is filled with a chalky liquid called barium.
Barium Enema
Also called: Lower GI Series
A barium enema, also called a lower GI series, is an x-ray exam used to help diagnose problems of the large intestine. To make the large intestine more visible on x-ray, the intestine is filled with a chalky liquid called barium.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative result means that there were no abnormalities found. Barium filled the colon evenly, showing normal bowel shape and position and no blockages.
Related conditions
A barium enema is an x-ray exam in which a liquid that contains barium sulfate is put through the anus into the rectum and colon. Barium sulfate is a silver-white metallic compound that helps show pictures of the colon, rectum, and anus on an x-ray.
https://www.niddk.nih.gov/health-information/diagnostic-tests/lower-gi-series [accessed on Sep 19, 2019]
https://medlineplus.gov/ency/article/003817.htm [accessed on Sep 19, 2019]
https://www.radiologyinfo.org/en/info.cfm?pg=lowergi [accessed on Sep 19, 2019]
https://www.healthline.com/health/barium-enema [accessed on Sep 19, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (11)
Screening and Diagnosis Barium Enema
A barium enema is an X-ray examination of the colon. To make the intestine visible on X-ray, a white liquid called barium is inserted into the colon through a tube placed in the anus. The barium blocks X-rays, causing the outline of the barium-filled colon to show up clearly on the X-ray image.
Image by TheVisualMD
Barium Enema
Double Contrast Barium Enema - Using Positive and Negative Contrast
Image by The original uploader was Glitzy queen00 at English Wikipedia
A barium swallow exam taken via fluoroscopy.
A barium swallow exam taken via fluoroscopy.
Image by Normaler_Schluck-00.jpg (and others): Hellerhoff
Upper gastrointestinal series
X-ray of the stomach with both positive (bariumsulphate) and negative (CO2)contrastmedia.
Image by Lucien Monfils
Hernia
X-rays image: Double Contrast Barium Enema depicting gas filled loop of colon trapped outside the normal peritoneal confines. This marks the entrance or exit of transdiafragmatic, colonic herniation.
Image by Nevit Dilmen (talk)
Peutz-Jeghers syndrome
Note multiple polyps (mostly pedunculated) and at least one large mass at the hepatic flexure coated with contrast.
Image by robhengxr
Upper gastrointestinal series
Barium follow though showing the small bowel.
Image by Glitzy queen00 at en.wikipedia
Diverticulosis and Diverticulitis
Representation of the rectum, colon and descending colon sigmoideums in double contrast in an X-ray contrast enema. In the distal descending colon and sigmoid, individual small protuberances indicate which are called diverticula.
Image by Bragel
Gastroesophageal reflux disease - Treatment for GER and GERD
Gastroesophageal reflux barium X-ray : X-ray of the abdomen and chest in a patient with a gastrostomy. Radio-contrast was injected into the stomach and quickly seen migrating upwards through the entire esophagus. The patient had severe reflux esophagitis.
Image by Steven Fruitsmaak
Double Contrast Barium Enema - Using Positive and Negative Contrast
Double Contrast Barium Enema - Using Positive and Negative Contrast
Image by Glitzy queen00
Lower GI Series
A lower GI series, also called a barium
enema, is an x-ray exam used to help
diagnose problems of the large intestine. An
x ray is a picture created by using radiation
and recorded on film or on a computer. To
make the large intestine more visible on x ray,
a health care provider will fill the person’s
intestine with a chalky liquid called barium.
Document by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Screening and Diagnosis Barium Enema
TheVisualMD
Barium Enema
The original uploader was Glitzy queen00 at English Wikipedia
A barium swallow exam taken via fluoroscopy.
Normaler_Schluck-00.jpg (and others): Hellerhoff
Upper gastrointestinal series
Lucien Monfils
Hernia
Nevit Dilmen (talk)
Peutz-Jeghers syndrome
robhengxr
Upper gastrointestinal series
Glitzy queen00 at en.wikipedia
Diverticulosis and Diverticulitis
Bragel
Gastroesophageal reflux disease - Treatment for GER and GERD
Steven Fruitsmaak
Double Contrast Barium Enema - Using Positive and Negative Contrast
Glitzy queen00
Lower GI Series
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Flexible Sigmoidoscopy
Sigmoidoscopy
Also called: Flexible Sigmoidoscopy, Rigid Sigmoidoscopy, Proctoscopy, Proctosigmoidoscopy
A sigmoidoscopy is a diagnostic test used to check the sigmoid colon, which is the lower part of your colon or large intestine. It is used to help diagnose bowel problems and detect colon polyps that can become colon cancer.
Sigmoidoscopy
Also called: Flexible Sigmoidoscopy, Rigid Sigmoidoscopy, Proctoscopy, Proctosigmoidoscopy
A sigmoidoscopy is a diagnostic test used to check the sigmoid colon, which is the lower part of your colon or large intestine. It is used to help diagnose bowel problems and detect colon polyps that can become colon cancer.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
A negative result means that no abnormalities were found in the colon. If you're at average risk of colon cancer, meaning you have no colon cancer risk factors other than age, your doctor may recommend repeating the exam in five years.
Related conditions
{"label":"Proctoscopy reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"The lining of the colon appears smooth and pink, with numerous folds. No abnormal growths, pouches, bleeding, or inflammation is seen.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"A proctoscopy can reveal various issues. An abnormal result may require further testing, such as a biopsy, or determine appropriate treatment for your condition.","conditions":["Hemorrhoids","Colon polyps","Colon cancer","Ulcer","Diverticulosis","Colitis"]}],"value":0.5,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
The lining of the colon appears smooth and pink, with numerous folds. No abnormal growths, pouches, bleeding, or inflammation is seen.
Related conditions
Sigmoidoscopy is a test in which 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.
A sigmoidoscope is of two types:
Rigid sigmoidoscope: This sigmoidoscope is 25 cm long, and it allows examination of up to about 20 cm of the rectum and colon.
Flexible sigmoidoscope: It is made of a flexible fiber-optic tube and can be up to 60 cm long. It allows examination of the descending colon.
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.
You may need a sigmoidoscopy to find the cause of unexplained symptoms such as:
Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
Changes in your bowel activity, such as diarrhea
Pain in your abdomen (belly)
Unexplained weight loss
Doctors also use the procedure to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
This test allows your provider to look at the lower part of the colon. During the test:
You will lie on an exam table with your knees drawn up to your chest.
A sigmoidoscope, a flexible, lighted tube with a camera, will be inserted into the rectum and up into the lower part of the colon.
Air will be pumped through the sigmoidoscope to make the colon bigger and easier to see.
The air may make you feel like you need to have a bowel movement or pass gas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
For a sigmoidoscopy, before the test, you may need to:
Follow a clear liquid diet one or more days before the procedure. This isn't always required, so be sure to talk to your provider before the test.
You may be asked to fast (not eat or drink) on the morning of the procedure.
Use an enema to empty your bowels about one hour before the procedure. A second enema is sometimes needed.
There are fewer risks to sigmoidoscopy than with a colonoscopy. Tears in the colon and bleeding can happen, but they are even less common than with a colonoscopy.
Normal findings are healthy intestinal tissues. Abnormal results may include the following:
Colorectal polyps or abnormal tissue were found. They may or may not be removed depending on their location.
Whether or not your polyps were removed, you will probably need a colonoscopy so your provider can view your entire colon and rectum.
If you have questions about your results, talk to your health care provider.
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Dec 28, 2018]
Colorectal Cancer Screening | Cancer Trends Progress Report [accessed on Dec 28, 2018]
Colorectal Cancer Screening (PDQ®)—Patient Version - National Cancer Institute [accessed on Dec 28, 2018]
Rigid and Flexible Sigmoidoscopy. MedicineNet [accessed on Feb 09, 2024]
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Feb 10, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (24)
Colorectal Cancer Screening
Video by Mechanisms in Medicine/YouTube
Testing for bowel cancer
Video by Cancer Research UK/YouTube
Screening for Cancer
Common Screening Tests and American Cancer Society Recommendations
Image by TheVisualMD
Screening & Diagnosis
Image by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 1
Colorectal Cancer Clip 1
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
Colonoscopy or sigmoidoscopy testing
Drawing of a woman being tested for colon polyps. The woman is lying on her left side with her head on a pillow. In the background is a TV screen showing images of the colon.
Image by NIDDK Image Library
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted and parts labeled: esophagus, stomach, liver, gallbladder, duodenum, pancreas, small intestine, colon, sigmoid colon, rectum, and anus
The digestive system focusing on the sigmoid colon, rectum, and anus.
Image by NIDDK Image Library
colonoscopy
SAN DIEGO (April 5, 2011) Hospitalman Urian D. Thompson, left, Lt. Cmdr. Eric A. Lavery and Registered Nurse Steven Cherry review the monitor while Lavery uses a colonoscope on a patient during a colonoscopy at Naval Medical Center San Diego. (U.S. Navy photo by Mass Communication Specialist 2nd Class Chad A. Bascom/Released)
Image by U.S. Navy photo by Mass Communication Specialist 2nd Class Chad A. Bascom
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Diagram showing a colonoscopy.
Image by Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
normal rectum colonoscopy
normal rectum 70y.o. Japanese / colonoscopy
Image by melvil
Familial adenomatous polyposis as seen on sigmoidoscopy
Familial adenomatous polyposis as seen on sigmoidoscopy
Image by Samir
Proctoscopy
Two proctoscopes
Image by Ralf Lotys (Sicherlich)
An anoscope, a proctoscope and a rectoscope, with approximate lengths
An anoscope, a proctoscope and a rectoscope, with approximate lengths
Image by Mikael Häggström
This browser does not support the video element.
Sigmoidoscopy: NCI B-roll [video]
NCI B-roll of a patient receiving a sigmoidoscopy. This video is silent. A version of this video with audio can be found in the video NCI Detection B-roll. Downloadable video files are 1280x720 at 30 fps. This image is part of the NCI B-Roll Videos collection.
View video using embedded player on this page or at youtube.com.
Video by National Cancer Institute (NCI)
Lower GI Series
A lower GI series, also called a barium
enema, is an x-ray exam used to help
diagnose problems of the large intestine. An
x ray is a picture created by using radiation
and recorded on film or on a computer. To
make the large intestine more visible on x ray,
a health care provider will fill the person’s
intestine with a chalky liquid called barium.
Document by National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted
The digestive system focusing on the sigmoid colon and stomach.
Image by NIDDK Image Library
Benign Tumor
Image of en:familial adenomatous polyposis as seen on en:sigmoidoscopy.
Image by Samir at English Wikipedia
What is a flexible sigmoidoscopy?
Video by You and Colonoscopy/YouTube
Colon Cancer Screening Tests: Flexible Sigmoidoscopy
Video by American Cancer Society/YouTube
Colon cancer: Essential facts
Video by Institute for Cancer Genetics and Informatics/YouTube
Screening for Colorectal Cancer
Video by Dartmouth-Hitchcock/YouTube
What to expect during a colonoscopy
Video by MD Anderson Cancer Center/YouTube
6 Reasons to Get a Colonoscopy
Video by Cleveland Clinic/YouTube
2:42
Colorectal Cancer Screening
Mechanisms in Medicine/YouTube
1:37
Testing for bowel cancer
Cancer Research UK/YouTube
Screening for Cancer
TheVisualMD
Screening & Diagnosis
TheVisualMD
0:15
Colorectal Cancer Clip 1
TheVisualMD
0:05
Colorectal Cancer Clip 6
TheVisualMD
Colonoscopy or sigmoidoscopy testing
NIDDK Image Library
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted and parts labeled: esophagus, stomach, liver, gallbladder, duodenum, pancreas, small intestine, colon, sigmoid colon, rectum, and anus
NIDDK Image Library
colonoscopy
U.S. Navy photo by Mass Communication Specialist 2nd Class Chad A. Bascom
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
normal rectum colonoscopy
melvil
Familial adenomatous polyposis as seen on sigmoidoscopy
Samir
Proctoscopy
Ralf Lotys (Sicherlich)
An anoscope, a proctoscope and a rectoscope, with approximate lengths
Mikael Häggström
1:17
Sigmoidoscopy: NCI B-roll [video]
National Cancer Institute (NCI)
Lower GI Series
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Drawing of the digestive system with sigmoid colon, rectum, and anus highlighted
NIDDK Image Library
Benign Tumor
Samir at English Wikipedia
1:55
What is a flexible sigmoidoscopy?
You and Colonoscopy/YouTube
2:49
Colon Cancer Screening Tests: Flexible Sigmoidoscopy
American Cancer Society/YouTube
2:49
Colon cancer: Essential facts
Institute for Cancer Genetics and Informatics/YouTube
4:06
Screening for Colorectal Cancer
Dartmouth-Hitchcock/YouTube
1:16
What to expect during a colonoscopy
MD Anderson Cancer Center/YouTube
3:17
6 Reasons to Get a Colonoscopy
Cleveland Clinic/YouTube
Colonoscopy Test
Colonoscopy
Also called: Coloscopy
Colonoscopy is an exam in which a doctor uses a colonoscope, to look inside your rectum and colon. Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
Colonoscopy
Also called: Coloscopy
Colonoscopy is an exam in which a doctor uses a colonoscope, to look inside your rectum and colon. Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
{"label":"Colonoscopy reference range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"negative","label":{"short":"Negative","long":"Negative","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"Normal findings are healthy intestinal tissues. If no abnormalities are discovered, an adult at average risk of colon cancer is generally advised to have a repeat colonoscopy 10 years until age 75.","conditions":[]},{"flag":"positive","label":{"short":"Positive","long":"Positive","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"The exam reveals polyps or other abnormalities in the colon. During the procedure, the doctor may remove polyps or perform biopsies of your ileum, colon, and\/or rectum.","conditions":["Hemorrhoids","Diverticular disease","Colonic polyps","Crohn disease","Ulcerative colitis","Infection","Bleeding","Colorectal cancer"]}],"value":0.5,"disclaimer":"Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are \"within normal limits.\""}[{"negative":0},{"positive":0}]
Use the slider below to see how your results affect your
health.
Your result is Negative.
Normal findings are healthy intestinal tissues. If no abnormalities are discovered, an adult at average risk of colon cancer is generally advised to have a repeat colonoscopy 10 years until age 75.
Related conditions
Colonoscopy is a exam in which a doctor uses a flexible tube with a camera on one end, called a colonoscope or scope, to look inside your rectum and colon. The rectum and colon make up most of your large intestine.
Colonoscopy can show irritated and swollen tissue, ulcers, polyps, and cancer.
A colonoscopy is used:
to look for early signs of cancer in the colon and rectum. It may be part of a routine screening, which usually starts at age 45.
to look for causes of unexplained changes in bowel habits
to evaluate symptoms like abdominal pain, rectal bleeding, and weight loss
Your doctor can also remove polyps from your colon during the procedure.
You may need a colonoscopy to find the cause of unexplained symptoms such as:
Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
Changes in your bowel activity, such as diarrhea
Pain in your abdomen (belly)
Unexplained weight loss
Doctors also use the procedure to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
This test allows a provider to view your entire colon and rectum. It is often done in an outpatient department of a hospital or medical center. Before the test, you will need to empty out your colon (large bowel) in a procedure called bowel prep. During the test:
You will lie on an exam table.
You will be given medicine called a sedative to help you relax. It also prevents you from feeling pain during the procedure. You may be awake for the test, but you probably won't remember anything.
A colonoscope, a thin, lighted tube with a camera attached, will be inserted into your rectum and up into your colon.
Your provider will look for colorectal polyps or other abnormal areas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
The sedative you are given may make you drowsy for several hours. You should arrange for someone to drive you home.
For a colonoscopy, you will need to do a bowel prep. Your provider will give you specific instructions on how to do your bowel prep, but steps for bowel prep may include:
Following a liquid diet for one to three days before the test.
Drinking plenty of clear liquids one to three days before the test. Clear liquids include water, black coffee or tea, fat-free broth, and sports drinks without added color.
Drinking a strong liquid laxative and/or using an enema on the evening before your test.
The laxative or enema will help you empty your bowels. You should prepare to spend a lot of time in the bathroom. Bowel prep can be inconvenient and uncomfortable, but if the colon is not thoroughly cleaned out, your provider may not be able to get a full picture of your colon and rectum. Polyps and other abnormal areas may not be seen.
Serious risks of colonoscopy are rare but can include:
Tears in the colon or rectum wall
Bleeding
Reaction to the sedative
Normal findings are healthy intestinal tissues. Abnormal results may include the following:
Colorectal polyps or abnormal tissue were found and removed.
Samples were sent to a lab for testing.
Most polyps aren't cancerous but can turn into cancer if not removed. Depending on the size and number of polyps, your provider may recommend more frequent colonoscopies.
If you have questions about your results, talk to your health care provider.
You may feel cramping in your abdomen or bloating during the first hour after the colonoscopy. If the doctor removed polyps or performed a biopsy, you may have light bleeding from your anus. This bleeding is normal.
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Feb 10, 2024]
Colonoscopy - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. Feb 10, 2024 [accessed on Feb 10, 2024]
Colonoscopy | MedlinePlus. National Library of Medicine. Dec 5, 2022 [accessed on Feb 10, 2024]
Colonoscopy: MedlinePlus Medical Encyclopedia [accessed on Feb 10, 2024]
Robert H. Shmerling, MD. Understanding the results of your colonoscopy - Harvard Health. Oct 14, 2020 [accessed on Feb 10, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (40)
This browser does not support the video element.
Colorectal Cancer Clip 6
Colorectal Cancer Clip 6
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 4
Colorectal Cancer Clip 4
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 3
Colorectal Cancer Clip 3
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Screening
Colorectal cancer is one of the few preventable forms of cancer thanks to effective screening. For many people, screening for colorectal cancer is an unpleasant thought, but knowing your options and taking a pro-active approach especially if you're over 50 can save your life. In this video, you can learn the "ins and outs" of colonoscopy, as well as learn about a new technique called virtual colonoscopy, which uses high-tech CT scans to screen the colon.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Screening & Diagnosis
Colorectal cancer includes cancer of both the colon and rectum. It is the fourth most common cancer in the United States and the second leading cause of cancer-related deaths affecting both men and women equally. The CDC recommends that everyone age 50 or over be screened. When diagnosed early, patients have a 90% 5-year survival rate.
Video by TheVisualMD
Preparing for a Colonoscopy
Video by Dartmouth-Hitchcock/YouTube
Why No One Should Be Afraid of a Colonoscopy
Video by Stanford Health Care/YouTube
What are Colonoscopy Risks? • Risks of Colonoscopy | Colonoscopy Center of Excellence
Video by La Peer/YouTube
Having a colonoscopy
Video by Cancer Research UK/YouTube
The Importance of Good Bowel Preparation During Colonoscopy
Video by Johns Hopkins Medicine/YouTube
What is a colonoscopy and how do I prepare for it?
Video by You and Colonoscopy/YouTube
Virtual Colonoscopy Q&A | Dr. Karen Horton
Video by Johns Hopkins Medicine/YouTube
What to expect during a colonoscopy
Video by MD Anderson Cancer Center/YouTube
6 Reasons to Get a Colonoscopy
Video by Cleveland Clinic/YouTube
Colonoscopy Video Tour: Removal of a Colon Polyp (Polypectomy)
Video by AmCollege Gastro/YouTube
What happens during and after a colonoscopy?
Video by You and Colonoscopy/YouTube
How to prepare for a colonoscopy
Video by MD Anderson Cancer Center/YouTube
Colonoscopy and Flexible Sigmoidoscopy
Video by Gastro Pros/YouTube
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
Video by University of California Television (UCTV)/YouTube
Screening for Colorectal Cancer
Video by Dartmouth-Hitchcock/YouTube
What is Colorectal Cancer?
Video by Stanford Health Care/YouTube
Rectal Cancer | Q&A
Video by Johns Hopkins Medicine/YouTube
5 Things to Know About Colonoscopy - The Nebraska Medical Center
Video by Nebraska Medicine Nebraska Medical Center/YouTube
Video by PreOp.com Patient Engagement - Patient Education/YouTube
UCSF Radiology: How is Virtual Colonoscopy Performed?
Video by UCSF Imaging/YouTube
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Diagram showing a colonoscopy.
Image by Cancer Research UK / Wikimedia Commons
Virtual Colonoscopy 3D Model
With virtual colonoscopy, a computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is then created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Virtual Colonoscopy Slice of CT Data
Virtual colonoscopy is a new imaging technology that uses computed tomography (CT) images to look for polyps and cancer in the colon. A computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Colonoscopy or sigmoidoscopy testing
Drawing of a woman being tested for colon polyps. The woman is lying on her left side with her head on a pillow. In the background is a TV screen showing images of the colon.
Image by NIDDK Image Library
Colorectal Cancer Types of Surgery
Surgery is the main treatment for colorectal cancer. Polyps and very early stage cancers (Stage 0 and some early Stage I tumors) can be removed during a colonoscopy, using a variety of techniques. In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied. If it isn't possible to perform a resection (for instance, if the cancer is at the outlet of the rectum), a colostomy may be performed. In a colostomy, a portion of the large intestine is brought through the abdominal wall to carry stool out of the body, where it empties into a special bag. The colostomy may be temporary in order to allow the colon or rectum time to heal after surgery, or it may be permanent.
Image by TheVisualMD
Sensitive content
This media may include sensitive content
Capsule endoscopy
Image of the colon acquired by capsule endoscopy
Image by Dr.HH.Krause
All Views
Inside
Outside
Unfurled
1
2
3
4
Virtual Colonoscopy
Virtual colonoscopy is a new technology that uses computerized tomography (CT) images to look for polyps and cancer in the colon. The result is a computer-generated, animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy is performed for removal or biopsy of the growth.
Interactive by TheVisualMD
Virtual Colonoscopy open colon section view
After the image-taking procedure is complete, the cross-sectional pictures are processed by the computer to create animated, three-dimensional images of the large intestine. They are examined by a radiologist to identify any abnormal growths. If abnormalities are found, a conventional colonoscopy will be performed so that the abnormal growths can be removed or biopsied.
Image by TheVisualMD
Screening and Diagnosis Colonoscopy
A colonoscopy is an examination of the interior of the colon. It is often used as a screening tool for early detection of colorectal cancer. During a colonoscopy, a long flexible tube with a video camera at one end, called a colonoscope, is inserted first into the anus and then into the colon. The doctor can view the inside of the colon along its entire length on a video monitor.
Image by TheVisualMD
A Less Invasive Look
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Image by TheVisualMD
Screening and Diagnosis Colonoscope
A colonoscopy is an examination of the interior of the colon. It is often used as a screening tool for early detection of colorectal cancer. During a colonoscopy, a long flexible tube with a video camera at one end, called a colonoscope, is inserted first into the anus and then into the colon. The doctor can view the inside of the colon along its entire length on a video monitor.
Image by TheVisualMD
Capsule endoscopy
Picture of a capsule
Image by Euchiasmus
Preparing for a colonoscopy
Video by AmerGastroAssn/YouTube
0:05
Colorectal Cancer Clip 6
TheVisualMD
0:15
Colorectal Cancer Clip 4
TheVisualMD
0:49
Colorectal Cancer Clip 3
TheVisualMD
4:13
Colorectal Cancer Screening
TheVisualMD
4:12
Colorectal Cancer Screening & Diagnosis
TheVisualMD
14:55
Preparing for a Colonoscopy
Dartmouth-Hitchcock/YouTube
3:35
Why No One Should Be Afraid of a Colonoscopy
Stanford Health Care/YouTube
2:56
What are Colonoscopy Risks? • Risks of Colonoscopy | Colonoscopy Center of Excellence
La Peer/YouTube
1:37
Having a colonoscopy
Cancer Research UK/YouTube
1:23
The Importance of Good Bowel Preparation During Colonoscopy
Johns Hopkins Medicine/YouTube
6:30
What is a colonoscopy and how do I prepare for it?
You and Colonoscopy/YouTube
8:26
Virtual Colonoscopy Q&A | Dr. Karen Horton
Johns Hopkins Medicine/YouTube
1:16
What to expect during a colonoscopy
MD Anderson Cancer Center/YouTube
3:17
6 Reasons to Get a Colonoscopy
Cleveland Clinic/YouTube
2:45
Colonoscopy Video Tour: Removal of a Colon Polyp (Polypectomy)
AmCollege Gastro/YouTube
5:15
What happens during and after a colonoscopy?
You and Colonoscopy/YouTube
8:08
How to prepare for a colonoscopy
MD Anderson Cancer Center/YouTube
2:49
Colonoscopy and Flexible Sigmoidoscopy
Gastro Pros/YouTube
1:26:06
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
University of California Television (UCTV)/YouTube
4:06
Screening for Colorectal Cancer
Dartmouth-Hitchcock/YouTube
3:47
What is Colorectal Cancer?
Stanford Health Care/YouTube
8:46
Rectal Cancer | Q&A
Johns Hopkins Medicine/YouTube
4:18
5 Things to Know About Colonoscopy - The Nebraska Medical Center
UCSF Radiology: How is Virtual Colonoscopy Performed?
UCSF Imaging/YouTube
Sensitive content
This media may include sensitive content
Diagram showing a colonoscopy
Cancer Research UK / Wikimedia Commons
Virtual Colonoscopy 3D Model
TheVisualMD
Virtual Colonoscopy Slice of CT Data
TheVisualMD
Colonoscopy or sigmoidoscopy testing
NIDDK Image Library
Colorectal Cancer Types of Surgery
TheVisualMD
Sensitive content
This media may include sensitive content
Capsule endoscopy
Dr.HH.Krause
Virtual Colonoscopy
TheVisualMD
Virtual Colonoscopy open colon section view
TheVisualMD
Screening and Diagnosis Colonoscopy
TheVisualMD
A Less Invasive Look
TheVisualMD
Screening and Diagnosis Colonoscope
TheVisualMD
Capsule endoscopy
Euchiasmus
1:15
Preparing for a colonoscopy
AmerGastroAssn/YouTube
Virtual Colonoscopy
Virtual Colonoscopy
Also called: Computed Tomographic Colonography, CT Colonography
Virtual colonoscopy is a non-invasive imaging method that uses computed tomographic data combined with specialized imaging software to examine the colon. It produces three-dimensional images of the colon which are examined for colorectal cancer and precancerous polyps.
Virtual Colonoscopy
Also called: Computed Tomographic Colonography, CT Colonography
Virtual colonoscopy is a non-invasive imaging method that uses computed tomographic data combined with specialized imaging software to examine the colon. It produces three-dimensional images of the colon which are examined for colorectal cancer and precancerous polyps.
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Use the slider below to see how your results affect your
health.
Your result is Negative.
No abnormalities were detected in the colon. If you're at average risk of colon cancer, meaning you have no colon cancer risk factors other than age, your doctor may recommend repeating the exam in five years.
Related conditions
A method to examine the inside of the colon by taking a series of x-rays. A computer is used to make 2-dimensional (2-D) and 3-D pictures of the colon from these x-rays. The pictures can be saved, changed to give better viewing angles, and reviewed after the procedure, even years later.
Also called computed tomographic colonography, computed tomography colonography, CT colonography, and CTC.
You may need a virtual colonoscopy to find the cause of unexplained symptoms such as:
Bleeding from your anus (the opening of the rectum through which stool passes out of your body)
Changes in your bowel activity, such as diarrhea
Pain in your abdomen (belly)
Unexplained weight loss
Doctors also use the procedure to screen for colon polyps and cancer. Screening is testing for diseases when you have no symptoms. It may find diseases at an early stage, when they are easier to treat. If aren't at higher risk for colorectal cancer, your health care provider will likely recommend you start getting screenings at age 45. If you at higher risk, you may need to start getting screened for colorectal cancer earlier.
There are also other tests to screen for colorectal cancer, including stool tests. Talk with your provider about which test is right for you and when and how often you should get it.
This is a type of x-ray that uses a CT scan (computed tomography) to take detailed, 3-dimensional pictures of the entire colon and rectum. It is usually done in a radiology department of a hospital or medical center. This procedure also requires bowel prep beforehand. During the test:
You will lie on a narrow table.
You may be asked to drink a liquid containing contrast dye. Contrast dye is a substance that makes parts of your body show up more clearly on an x-ray.
A provider will insert a small tube into the rectum.
Air will be pumped through the tube to make the colon bigger and easier to see.
The table will slide into the CT machine.
A series of images will be taken.
For a virtual colonoscopy, you will need to do a bowel prep. Your provider will give you specific instructions on how to do your bowel prep, but steps for bowel prep may include:
Following a liquid diet for one to three days before the test.
Drinking plenty of clear liquids one to three days before the test. Clear liquids include water, black coffee or tea, fat-free broth, and sports drinks without added color.
Drinking a strong liquid laxative and/or using an enema on the evening before your test.
The laxative or enema will help you empty your bowels. You should prepare to spend a lot of time in the bathroom. Bowel prep can be inconvenient and uncomfortable, but if the colon is not thoroughly cleaned out, your provider may not be able to get a full picture of your colon and rectum. Polyps and other abnormal areas may not be seen.
In a virtual colonoscopy, risks include:
Exposure to a small dose of radiation from the scan.
Rarely, a tear in the colon or rectum can happen when it is inflated with air.
Normal findings are healthy intestinal tissues. Abnormal results may include the following:
Colorectal polyps or abnormal tissue were seen on the CT scan.
You will probably need a traditional colonoscopy so your provider can get a tissue sample. Sometimes this procedure can be done on the same day as your virtual colonoscopy.
If you have questions about your results, talk to your health care provider.
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Feb 12, 2024]
Colonoscopy | MedlinePlus. National Library of Medicine. Dec 5, 2022 [accessed on Feb 12, 2024]
Virtual Colonoscopy | NIDDK [accessed on Dec 28, 2018]
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Dec 28, 2018]
Colorectal Cancer Screening | Cancer Trends Progress Report [accessed on Dec 28, 2018]
CT Colonography [accessed on Dec 28, 2018]
Virtual colonoscopy - Mayo Clinic [accessed on Dec 28, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (14)
Virtual Colonoscopy 3D Model
With virtual colonoscopy, a computed tomography scanner takes cross-sectional images of the patient's colon, after the colon has been inflated with gas. A three-dimensional model is then created from the CT slices and evaluated by a radiologist for abnormalities.
Image by TheVisualMD
Virtual Colonoscopy open colon section view
After the image-taking procedure is complete, the cross-sectional pictures are processed by the computer to create animated, three-dimensional images of the large intestine. They are examined by a radiologist to identify any abnormal growths. If abnormalities are found, a conventional colonoscopy will be performed so that the abnormal growths can be removed or biopsied.
Image by TheVisualMD
A Less Invasive Look
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Image by TheVisualMD
This browser does not support the video element.
Colon unfurling
Virtual colonoscopy is a new technology that uses computed tomography (CT), or, less often, magnetic resonance imaging (MRI) images to look for polyps, cancer, or other diseases of the colon when an abnormality is suspected. A computer program assembles the images to create an animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy will need to be performed for removal or biopsy of the growth.
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 3
Colorectal Cancer Clip 3
Video by TheVisualMD
This browser does not support the video element.
Colorectal Cancer Clip 4
Colorectal Cancer Clip 4
Video by TheVisualMD
Spectrum of Medical Imaging
This composite image was created in recognition of The Society of Photo-Optical Instrumentation Engineers (SPIE) designation of 2015 as the “International Year of Light.” Medical imaging scientists and engineers contribute to the quest for the improved human condition by providing imaging that spans the entire usable electro-magnetic spectrum (seen at bottom). From the humblest of beginnings with simple magnification of objects and focusing with lenses, to the biological observation of cells with rudimentary microscopes in the visible spectrum, medical imaging today has both extended away from the visible spectrum towards longer and shorter wavelengths (low and high energies) and exploited the hyperspectral nature of the visible which was once considered “commonplace” or rudimentary. Considering yet a different cross-section through the various imaging modalities across the spectrum, the medically useful information gained spans anatomic, physiologic, and molecular regimes. Systems and algorithms have been developed as single-modality acquisition systems, and also as multiple-modalities with conjoint reconstruction, each informing the other in the quest to optimize image quality and information content. In addition, the role of light-based technologies in enabling advanced computations in tomographic reconstructions, computer-aided diagnosis, machine learning (neural networks, deep learning, etc.) , and 3D visualizations as well as in data-enriched storage of medical images has further extended the potential knowledge “seen” through imaging. The breadth of the electromagnetic spectrum offers limitless opportunities for improvement and inquiry, in our quest to answer human life’s difficult questions. This montage was first published on the cover of the SPIE’s Journal of Medical Imaging (July-Sept. 2015, vol. 3, no. 3) and is but a small tribute to the multitude of medical imaging scientists who have contributed to the wealth of new knowledge as we interrogate the human condition. The gray-scale whole body images (from Left to Right) are acquired from longer wavelength modalities to shorter wavelength modalities spanning the (currently) usable electromagnetic spectrum. The background images include: a coronal Magnetic Resonance Image (MRI) T2 weighted image slice, a posterior surface Infra Red (IR) heat map, a coronal non-contrast Computed Tomography (CT) slice, and a coronal 18F-fluoro-deoxyglucose Positron Emission Tomography (FDG-PET) slice. The selection of color inset images includes (from Top-to-Bottom, then Left to Right): [1] diffusion tensor magnetic resonance imaging (MRI) used to image long white matter tracts within and around the human brain illustrating neuronal connectivity (coloring refers to bluish=vertical direction; green=horizontal A-P direction; red=horizontal lateral direction) (courtesy of Arthur Toga, PhD); [2] registered and superimposed coronal proton-MRI (gray-scale) and a hyper polarized 129Xe ventilation MRI scan (color scale) within the same patient’s lungs, prior to their receiving a bronchial stent (courtesy of Bastiaan Driehuys, PhD); [3] coronal slice through a microwave-based image reconstruction of the Debye parameter ε (epsilon) in a heterogeneously dense human breast phantom (courtesy of Susan Hagness, PhD); [4] juxtaposed optical image of the retina and vertical and horizontal Optical Coherence Tomograph (OCT) slices showing pigmentosa retinopathy (courtesy of Jean-Michel Muratet, MD); [5] functional 3-D photoacoustic imaging of melanoma (gray scale) in vivo, surrounded by highly optically absorptive blood vessels (red) (courtesy of Lihong Wang, PhD); [6] optical micrograph of HeLa cells stained for microtubules (blue) and co-stained with DAPI for actin visualization (red); HeLa cells are the world's first stem cell line, originally derived from the aggressive cervical cancer cells of Henrietta Lacks (courtesy Tom Deerinck/NCMIR); [7] visualization of the pelvis highlighting the colon, which is imaged with contrast x-ray computed tomography (CT), and after digital surface rendering can be used in virtual colonoscopy, thus avoiding a physical visible light-based colonoscopy; [8] registered and fused sagittal 99mTc-sestamibi dedicated molecular single photon emission computed tomography (SPECT, heat color scale) and low-dose CT slice (gray scale) of a patient’s uncompressed, pendant breast containing two surgically confirmed DCIS loci in the posterior breast (courtesy of Martin Tornai, PhD); [9] classic, early x-radiograph of Wilhelm Röntgen’s wife’s hand (adapted from http://en.wikipedia.org/wiki/100_Photographs_that_Changed_the_World); [10] transverse pelvic CT (gray scale) with multiple superimposed simulated x-ray photon radiotherapy beams, and their cumulative 20Gy (red) deposited dose isocontours at the focus of a tumor (courtesy of Paul Read, MD, PhD); [11] false-colored scanning electron micrograph of human immunodeficiency virus (HIV) particles (yellow) infecting a human H9 T-cell (turquoise) (adapted from http://biosingularity.com/category/infection/); [12] transverse 18F-dopa positron emission tomography (PET) slice through a Parkinson patient’s brain showing decreased in vivo quantitative uptake in the right caudate and putamen (courtesy of Christaan Schiepers, MD, PhD); [13] registered and fused transverse head CT (gray scale) and registered superimposed PET image (color) of a patient immediately after radio-therapeutic proton irradiation showing endogenously created 15O-positron emitter (2 min half-life) within the nasopharyngeal tumor focus (courtesy of Kira Grogg, PhD). [14] transverse (long axis) cardiac 99mTc-sestamibi SPECT slice illustrating thinned myocardial apical wall in a procedure performed thousands of times daily around the world (adapted from www.medscape.com). These images are but a small sampling of the breadth of the spectrum of light that is currently being investigated the world over by passionate scientists and engineers on a quest for the betterment of the human condition. All contributors for these images used herein have given their permission for their use, and are graciously thanked.
Image by Martin Tornai
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
Video by University of California Television (UCTV)/YouTube
Virtual Colonoscopy Q&A | Dr. Karen Horton
Video by Johns Hopkins Medicine/YouTube
All Views
Inside
Outside
Unfurled
1
2
3
4
Virtual Colonoscopy
Virtual colonoscopy is a new technology that uses computerized tomography (CT) images to look for polyps and cancer in the colon. The result is a computer-generated, animated, three-dimensional view of the interior of the colon. The preparation for the procedure is similar to that for a colonoscopy, but the procedure itself takes only about 10 minutes, and no sedation is required. If abnormalities are found, a conventional colonoscopy is performed for removal or biopsy of the growth.
Interactive by TheVisualMD
UCSF Radiology: How is Virtual Colonoscopy Performed?
Video by UCSF Imaging/YouTube
Virtual Colonoscopy - Lexington Diagnostic Center
Video by Lexington Diagnostic Center/YouTube
Virtual Colonoscopy-Mayo Clinic
Video by Mayo Clinic/YouTube
3D Visualization of Colon and Virtual Colonoscopy
3D Visualization of Colon and Virtual Colonoscopy
Image by TheVisualMD
Virtual Colonoscopy 3D Model
TheVisualMD
Virtual Colonoscopy open colon section view
TheVisualMD
A Less Invasive Look
TheVisualMD
0:13
Colon unfurling
TheVisualMD
0:49
Colorectal Cancer Clip 3
TheVisualMD
0:15
Colorectal Cancer Clip 4
TheVisualMD
Spectrum of Medical Imaging
Martin Tornai
1:26:06
Virtual Colonoscopy: A Kinder Gentler Way to Prevent Colon Cancer
University of California Television (UCTV)/YouTube
8:26
Virtual Colonoscopy Q&A | Dr. Karen Horton
Johns Hopkins Medicine/YouTube
Virtual Colonoscopy
TheVisualMD
2:33
UCSF Radiology: How is Virtual Colonoscopy Performed?
UCSF Imaging/YouTube
2:24
Virtual Colonoscopy - Lexington Diagnostic Center
Lexington Diagnostic Center/YouTube
2:19
Virtual Colonoscopy-Mayo Clinic
Mayo Clinic/YouTube
3D Visualization of Colon and Virtual Colonoscopy
TheVisualMD
Stool DNA Test
Stool DNA Test
Also called: Cologuard®, Fecal DNA, Genetic Stool Test, DNA Stool Test, FIT-DNA, Multi-Target Stool DNA, sDNA-FIT, MT-sDNA Test, At-Home Colorectal Cancer Screening Test
A stool DNA test is a noninvasive test that checks for altered DNA and hidden blood in a sample of your stool. The presence of abnormal cells or blood in the stool may be signs of colorectal polyps or cancer. The test is intended for adults 45 and older at average risk for colorectal cancer.
Stool DNA Test
Also called: Cologuard®, Fecal DNA, Genetic Stool Test, DNA Stool Test, FIT-DNA, Multi-Target Stool DNA, sDNA-FIT, MT-sDNA Test, At-Home Colorectal Cancer Screening Test
A stool DNA test is a noninvasive test that checks for altered DNA and hidden blood in a sample of your stool. The presence of abnormal cells or blood in the stool may be signs of colorectal polyps or cancer. The test is intended for adults 45 and older at average risk for colorectal cancer.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal, or negative, result means that the test did not detect blood cells or altered DNA in your stool sample. If you have an average risk of colon or rectal cancer, you don't need further testing for colorectal cancer.
Related conditions
A stool DNA test combines a fecal immunochemical test (FIT) with a test that detects altered DNA in the stool. It is also called a FIT-DNA test. The test is used to screen for colon and rectal cancer in people at average risk. The only stool DNA test approved by the FDA to date is Cologuard®.
The test detects hemoglobin, along with certain DNA biomarkers. 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.
For this test, you collect an entire bowel movement and send it to a lab, where it is checked for altered DNA and for the presence of blood. It is done once every three years.
The National Cancer Institute and other expert medical groups recommend people get regular screenings for colorectal cancer, starting at age 50. The American Cancer Society recommends that people begin screening at age 45. You should talk with your healthcare provider about when you should start and about the different types of screening tests.
Stool tests look at stool samples for signs of cancer. For these tests, you take a stool sample at home and send it to a lab.
Your healthcare provider will let you know to get a test kit. The kit will include instructions on how to do the test. The instructions will likely include the following steps:
Put a special container inside your toilet.
Collect an entire bowel movement.
Close and seal the container.
Mail the container with the stool sample to a lab for testing.
There are no special preparations needed for a stool DNA test.
There are no risks to having a stool DNA test.
If your stool DNA test had abnormal results, it doesn't necessarily mean you have cancer. But your healthcare provider will probably order more tests, such as a colonoscopy, to help make a diagnosis.
The test isn't always accurate. In one study of people who were at average risk of developing colon cancer and had no symptoms of colon problems, the stool DNA test was more sensitive than the FIT test alone. However, the stool 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).
If you have questions about your results, talk to your healthcare provider.
There are different types of colorectal cancer screening tests. Each type of test has advantages and disadvantages. You and your healthcare provider should discuss the benefits and risks of each option.
Advantages of a stool DNA test
Disadvantages of a stool DNA test
No risk to colon
No bowel prep
Sample can be collected at home
Can have false positives
Cannot detect precancerous changes
May miss some cancers
Colonoscopy will be needed if results are abnormal
Should be done every three years
Fairly new test; may not be covered by insurance
Cologuard: MedlinePlus Medical Encyclopedia [accessed on Apr 20, 2023]
Colorectal Cancer Screening Tests: MedlinePlus Medical Test [accessed on Apr 20, 2023]
Tests to Detect Colorectal Cancer and Polyps - National Cancer Institute [accessed on Apr 20, 2023]
Stool DNA test - Mayo Clinic [accessed on Apr 20, 2023]
Stool DNA | The Colorectal Cancer Alliance [accessed on Apr 20, 2023]
Cologuard: A New Test For Reducing The Risk Of Colon Cancer | Cancer Prevention [accessed on Apr 20, 2023]
Stool DNA Test - Testing.com. Nov 9, 2021 [accessed on Apr 20, 2023]
Understanding Your Test Results | Cologuard® Patient Site [accessed on Apr 20, 2023]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Cologuard®: Can I Collect a Stool Sample During a Menstrual Cycle?
Cologuard/YouTube
1:08
Preparing to Use Cologuard®
Cologuard/YouTube
1:08
Reminders to Complete a Cologuard® Kit, Explained
Cologuard/YouTube
0:38
Preparing to Use Cologuard®: Diet and Medications
Cologuard/YouTube
1:05
Collecting a Cologuard® Sample: Size
Cologuard/YouTube
1:29
Cologuard®: Is There Any Time I Should Not Collect a Stool Sample?
Cologuard/YouTube
1:12
Cologuard®: Should I Collect a Sample If I Have Hemorrhoids?
Cologuard/YouTube
1:04
Cologuard®: Collecting a Stool Sample with Loose Stool or Diarrhea
Cologuard/YouTube
1:05
Cologuard®: What Happens If I Get Urine into the Collection Container?
Cologuard/YouTube
0:51
Cologuard®: What If I Make a Mistake Collecting My Stool Sample?
Cologuard/YouTube
0:40
Cologuard®: Expiration Date
Cologuard/YouTube
1:10
Preparing to Return a Completed Cologuard® Kit
Cologuard/YouTube
0:57
Cologuard® Sample Label Tips
Cologuard/YouTube
1:00
How to Return a Completed Cologuard® Kit with UPS®
Cologuard/YouTube
0:56
When to Collect a Sample
Cologuard/YouTube
0:31
Cologuard® Commercial: When You're 45 2.0
Cologuard/YouTube
6:39
What You Need To Know About Men's Health
Prostate Cancer Research Institute/YouTube
5:53
Some people are facing pricey medical bills after using popular at-home colon cancer test
CBS Mornings/YouTube
3:13
Cologuard - SNL
Saturday Night Live/YouTube
Colorectal Cancer Screening Tests
Colorectal Cancer Screening Tests
Also called: Colon cancer screening
Colorectal cancer screening tests check for signs of colorectal cancer. There are several types of colorectal cancer screening tests; each has different benefits and risks. Talk to your health care provider about which type of test is best for you.
Colorectal Cancer Screening Tests
Also called: Colon cancer screening
Colorectal cancer screening tests check for signs of colorectal cancer. There are several types of colorectal cancer screening tests; each has different benefits and risks. Talk to your health care provider about which type of test is best for you.
Colorectal cancer screening tests check for signs of colorectal cancer. Colorectal cancer is a type of cancer that affects the colon or rectum. The colon makes up most of the large intestine. The rectum is at the end of the large intestine and connects to the anus.
Colorectal cancer is a leading cause of cancer deaths in the United States. Screening can help find colorectal cancer early, when treatment is most effective. Colorectal cancer screening can sometimes prevent cancer from even developing. That's because some types of screening tests let a health care provider find and remove abnormal growths, known as colorectal polyps. Most of these polyps are benign (not cancerous) but do have a risk of becoming cancerous if not removed.
Colorectal cancer screening tests are used to check for signs of colorectal cancer and/or to remove colorectal polyps.
The National Cancer Institute and other expert medical groups recommend people get regular screenings for colorectal cancer, starting at age 50. The American Cancer Society recommends that people begin screening at age 45. You should talk with your health care provider about when you should start and about the different types of screening tests.
You may need to be screened at a younger age, or more often, if you have certain risk factors including:
A family history of colorectal cancer
Previously had colorectal polyps
A family history of, or having had, ovarian cancer
Inflammatory bowel disease such as ulcerative colitis or Crohn's disease
There are two main types of colorectal cancer screening tests: visual exams and stool tests. There are different options for both types of tests.
Visual exams are procedures that allow a provider to look inside the colon and rectum. They are done either using a thin tube with a camera attached or with a special imaging device. Types of visual exams include:
Colonoscopy. This test allows a provider to view your entire colon and rectum. It is often done in an outpatient department of a hospital or medical center. Before the test, you will need to empty out your colon (large bowel) in a procedure called bowel prep. During the test:
You will lie on an exam table.
You will be given medicine called a sedative to help you relax. It also prevents you from feeling pain during the procedure. You may be awake for the test, but you probably won't remember anything.
A colonoscope, a thin, lighted tube with a camera attached, will be inserted into your rectum and up into your colon.
Your provider will look for colorectal polyps or other abnormal areas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
The sedative you are given may make you drowsy for several hours. You should arrange for someone to drive you home.
Sigmoidoscopy. This test allows your provider to look at the lower part of the colon. During the test:
You will lie on an exam table with your knees drawn up to your chest.
A sigmoidoscope, a flexible, lighted tube with a camera, will be inserted into the rectum and up into the lower part of the colon.
Air will be pumped through the sigmoidoscope to make the colon bigger and easier to see.
The air may make you feel like you need to have a bowel movement or pass gas.
Your provider may remove polyps or tissue samples using special tools inserted through the scope.
Polyps or samples may be sent to a lab for testing.
Virtual Colonoscopy. This is a type of x-ray that uses a CT scan (computed tomography) to take detailed, 3-dimensional pictures of the entire colon and rectum. It is usually done in a radiology department of a hospital or medical center. This procedure also requires bowel prep beforehand. During the test:
You will lie on a narrow table.
You may be asked to drink a liquid containing contrast dye. Contrast dye is a substance that makes parts of your body show up more clearly on an x-ray.
A provider will insert a small tube into the rectum.
Air will be pumped through the tube to make the colon bigger and easier to see.
The table will slide into the CT machine.
A series of images will be taken.
Stool tests look at stool samples for signs of cancer. For these tests, you take a stool sample at home and send it to a lab. Types of stool tests:
Fecal occult blood tests. These tests look for hidden (known as occult) blood in the stool. Blood in the stool may be a sign of polyps, cancer, or other conditions. Your health care provider will give you a kit that includes instructions on how to do the test.
There are two types of fecal occult blood tests: the fecal immunochemical test (FIT) and the guaiac smear method (gFOBT). Below are typical instructions for each test. Your instructions may vary slightly depending on the manufacturer of the test kit.
For a fecal immunochemical test (FIT), you will most likely need to:
Collect samples from two or three separate bowel movements.
Collect the sample from the toilet using the special brush or other device included in your kit.
For each sample, use the brush or device to take the sample from the surface of the stool.
Brush the sample onto a test card.
Label and seal all your samples as directed.
Mail the samples to your health care provider or lab.
For a guaiac smear test (gFOBT), you will most likely need to:
Collect samples from three separate bowel movements.
For each sample, collect the stool and store it in a clean container. Make sure the sample does not mix in with urine or water from the toilet.
Use the applicator from your test kit to smear some of the stool on the test card or slide, also included in your kit.
Label and seal all your samples as directed.
Mail the samples to your health care provider or lab.
Stool DNA test. This test checks for genetic changes in the stool that may be signs of colorectal polyps or cancer. Your provider will let you know to get a test kit. The kit will include instructions on how to do the test. The instructions will likely include the following steps:
Put a special container inside your toilet.
Collect an entire bowel movement.
Close and seal the container.
Mail the container with the stool sample to a lab for testing.
There are no special preparations needed for a FIT or stool DNA test. The typical preparations for other colorectal cancer screening tests are below.
For a colonoscopy and virtual colonoscopy, you will need to do a bowel prep. Your provider will give you specific instructions on how to do your bowel prep, but steps for bowel prep may include:
Following a liquid diet for one to three days before the test.
Drinking plenty of clear liquids one to three days before the test. Clear liquids include water, black coffee or tea, fat-free broth, and sports drinks without added color.
Drinking a strong liquid laxative and/or using an enema on the evening before your test.
The laxative or enema will help you empty your bowels. You should prepare to spend a lot of time in the bathroom. Bowel prep can be inconvenient and uncomfortable, but if the colon is not thoroughly cleaned out, your provider may not be able to get a full picture of your colon and rectum. Polyps and other abnormal areas may not be seen.
For a sigmoidoscopy, before the test, you may need to:
Follow a clear liquid diet one or more days before the procedure. This isn't always required, so be sure to talk to your provider before the test.
You may be asked to fast (not eat or drink) on the morning of the procedure.
Use an enema to empty your bowels about one hour before the procedure. A second enema is sometimes needed.
For a g(FOBT) test, you may need to avoid the following foods and medicines for several days before your test:
Nonsteroidal, anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, or aspirin
More than 250 mg of vitamin C daily from supplements, fruit juices, or fruit
Red meat, such as beef, lamb, or pork
Your health care provider will give you full instructions on how to prepare for your screening test.
There are no risks to having a fecal occult blood test or a stool DNA test.
Serious risks of colonoscopy are rare but can include:
Tears in the colon or rectum wall
Bleeding
Reaction to the sedative
There are fewer risks to sigmoidoscopy than with a colonoscopy. Tears in the colon and bleeding can happen, but they are even less common than with a colonoscopy.
In a virtual colonoscopy, risks include:
Exposure to a small dose of radiation from the scan.
Rarely, a tear in the colon or rectum can happen when it is inflated with air.
If your fecal occult blood test or stool DNA test had abnormal results, it doesn't necessarily mean you have cancer. But your provider will probably order more tests, such as a colonoscopy, to help make a diagnosis.
Abnormal results for the other types of screening tests may include the following:
Colonoscopy
Colorectal polyps or abnormal tissue were found and removed.
Samples were sent to a lab for testing.
Most polyps aren't cancerous but can turn into cancer if not removed. Depending on the size and number of polyps, your provider may recommend more frequent colonoscopies.
Sigmoidoscopy
Colorectal polyps or abnormal tissue were found. They may or may not be removed depending on their location.
Whether or not your polyps were removed, you will probably need a colonoscopy so your provider can view your entire colon and rectum.
Virtual colonoscopy
Colorectal polyps or abnormal tissue were seen on the CT scan.
You will probably need a traditional colonoscopy so your provider can get a tissue sample. Sometimes this procedure can be done on the same day as your virtual colonoscopy.
If you have questions about your results, talk to your health care provider.
Each type of screening test has advantages and disadvantages. You and your provider should discuss the benefits and risks of each option. The following may help guide your decision.
Colonoscopy
Advantages
Looks at the entire colon
Can remove polyps and test for cancer
May help find other diseases
Needed only every 10 years (if no polyps were found in previous tests)
Disadvantages
Small risk of tears and bleeding
Bowel prep needed
Sedatives are needed for the procedure
Takes at least one day for bowel prep and recovery
Sigmoidoscopy
Advantages
Usually doesn't require bowel prep
Sedatives are not usually needed
Needed every five years (if no polyps were found in previous tests)
Disadvantages
Only looks at a third of the colon
May miss small polyps
Can't remove all polyps
Very small risk of tears or bleeding
Not widely used as a screening test
Colonoscopy will be needed if results are abnormal
Virtual Colonoscopy
Advantages
Looks at the entire colon
Sedatives not needed
Needed every five years (if no polyps were found in previous tests)
Disadvantages
Bowel prep needed
May miss small polyps
Exposure to a small amount of radiation
Traditional colonoscopy will be needed if results are abnormal
Fairly new test; may not be covered by insurance
Fecal immunochemical test (FIT)
Advantages
No risk to colon
No bowel prep
Sample can be collected at home
Disadvantages
Can have false positives
Cannot detect precancerous changes (cells that are at risk for turning into cancer)
May miss some signs of polyps and/or cancer
Colonoscopy will be needed if results are abnormal
Should be done every year
Guaiac smear test (gFOBT)
Advantages
No risk to colon
No bowel prep
Sample can be collected at home
Disadvantages
Can have false positives
Cannot detect precancerous changes
May miss some signs of polyps and/or cancer
Dietary restrictions required before testing
Colonoscopy will be needed if results are abnormal
Should be done every year
Stool DNA
Advantages
No risk to colon
No bowel prep
Sample can be collected at home
Disadvantages
Can have false positives
Cannot detect precancerous changes
May miss some cancers
Colonoscopy will be needed if results are abnormal
Should be done every three years
Fairly new test; may not be covered by insurance
Additional Materials (23)
Colorectal Cancer Screening
Document by CDC
Colorectal Cancer Screening
Document by CDC
Colorectal Cancer Screening Saves Lives
Document by CDC
Screening Tests At-A-Glance - Colorectal Cancer Screening Saves Lives
Document by CDC
Risk Factors & Symptoms - Colorectal Cancer Screening Saves Lives
Document by CDC
True or false? Colorectal Cancer Screening
Document by CDC
Cancer and obesity
Document by Centers for Disease Control and Prevention (CDC)
Is it time to get your colon checked?
Colorectal—or colon—cancer is one of the most common cancers in the U.S. It's also one of the most treatable, especially if detected early.
Screening can not only detect colon cancer early but also can reduce your risk of developing colon cancer by finding and removing colon polyps, some of which can progress to cancer. Most medical groups recommend that people at average risk of colorectal cancer get screened regularly beginning at age 50 with a either a colonoscopy or an at-home test. However, you may be advised to start earlier if you or a close relative have had colon polyps, an inflammatory bowel disease, colon cancer, or other risk factors. Check with your health care provider to learn when—and how— you should get checked.
Document by NIH MedlinePlus Magazine
Do You Know Tony? Family History of Colorectal Cancer
Tony, 35, knows he has a lot to
be thankful for: a great job, a
nice home and a terrific family.
He also knows he owes a debt
of gratitude to his primary
care provider.
Document by National Human Genome Research Institute (NHGRI)
Cancer Health Disparities
Document by Center for Disease Control and Prevention
Physical Activity and Cancer
Being physically active lowers your risk for developing several commonly occurring cancers.
Document by CDC
This browser does not support the video element.
Colorectal Cancer Screening & Diagnosis
Colorectal cancer includes cancer of both the colon and rectum. It is the fourth most common cancer in the United States and the second leading cause of cancer-related deaths affecting both men and women equally. The CDC recommends that everyone age 50 or over be screened. When diagnosed early, patients have a 90% 5-year survival rate.
Video by TheVisualMD
This browser does not support the video element.
Drs. Klein and O'Kieffe on how screening is prevention
Dr Mark Klein, a radiologist and specialist in virtual colonoscopy, and Dr. Donald O'Kieffe, a gastroenterologist and specialist in optical colonoscopy both stress the importance of screening for colorectal cancer. Thanks to Washington Radiology Associates and Metro Gastroenterology of the Washington, DC area.
Video by TheVisualMD
What is Colon Cancer? | At Home Colon Screening
Video by LetsGetChecked/YouTube
Easy Colon Cancer Screening at Home
Video by My Doctor - Kaiser Permanente/YouTube
Colon Cancer: At-Home Screening with Stool-Based Testing
Video by uvahealth/YouTube
Colorectal Cancer Screening
Video by Mechanisms in Medicine/YouTube
At-home tests effective for colon cancer screening
Video by CBS News/YouTube
Colon Cancer Prevention
Video by Sutter Health/YouTube
How to prepare for a colonoscopy
Video by MD Anderson Cancer Center/YouTube
Colorectal Cancer Prevention | Cedars-Sinai
Video by Cedars-Sinai/YouTube
How To Use Cologuard (English)
Video by Cologuard/YouTube
FIT is a colorectal cancer screening test
Image by Veterans Administration
Colorectal Cancer Screening
CDC
Colorectal Cancer Screening
CDC
Colorectal Cancer Screening Saves Lives
CDC
Screening Tests At-A-Glance - Colorectal Cancer Screening Saves Lives
CDC
Risk Factors & Symptoms - Colorectal Cancer Screening Saves Lives
CDC
True or false? Colorectal Cancer Screening
CDC
Cancer and obesity
Centers for Disease Control and Prevention (CDC)
Is it time to get your colon checked?
NIH MedlinePlus Magazine
Do You Know Tony? Family History of Colorectal Cancer
National Human Genome Research Institute (NHGRI)
Cancer Health Disparities
Center for Disease Control and Prevention
Physical Activity and Cancer
CDC
4:12
Colorectal Cancer Screening & Diagnosis
TheVisualMD
0:26
Drs. Klein and O'Kieffe on how screening is prevention
TheVisualMD
3:17
What is Colon Cancer? | At Home Colon Screening
LetsGetChecked/YouTube
1:10
Easy Colon Cancer Screening at Home
My Doctor - Kaiser Permanente/YouTube
2:49
Colon Cancer: At-Home Screening with Stool-Based Testing
uvahealth/YouTube
2:42
Colorectal Cancer Screening
Mechanisms in Medicine/YouTube
1:56
At-home tests effective for colon cancer screening
CBS News/YouTube
2:12
Colon Cancer Prevention
Sutter Health/YouTube
8:08
How to prepare for a colonoscopy
MD Anderson Cancer Center/YouTube
1:39
Colorectal Cancer Prevention | Cedars-Sinai
Cedars-Sinai/YouTube
3:57
How To Use Cologuard (English)
Cologuard/YouTube
FIT is a colorectal cancer screening test
Veterans Administration
Staging
Colorectal Cancer Confined to Colon Wall Stage 0
Colorectal Cancer Spread Past Mucosa Stage 1
Colorectal Cancer Spread Into Colon Stage 2
Colorectal Cancer Spread to Lymph Nodes Stage 3
Colorectal Cancer Spread to Body Stage 4
1
2
3
4
5
Colorectal Cancer Spread to Body
Interactive by TheVisualMD
Colorectal Cancer Confined to Colon Wall Stage 0
Colorectal Cancer Spread Past Mucosa Stage 1
Colorectal Cancer Spread Into Colon Stage 2
Colorectal Cancer Spread to Lymph Nodes Stage 3
Colorectal Cancer Spread to Body Stage 4
1
2
3
4
5
Colorectal Cancer Spread to Body
Cancer spreads in three ways: by invading surrounding tissue, by invading the lymph system and traveling through lymph vessels to other places in the body, and by invading veins and capillaries and traveling through the bloodstream to other places in the body. Stage III: Cancer has spread to nearby tissues or organs and lymph nodes, but not to distant parts of the body.
Interactive by TheVisualMD
What Are the Stages of Colon Cancer?
After colon cancer has been diagnosed, tests are done to find out if cancer cells have spread within the colon or to other parts of the body.
The process used to find out if cancer has spread within the colon or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.
The following tests and procedures may be used in the staging process:
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the abdomen, pelvis, or chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the colon. A substance called gadolinium is injected into the patient through a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
Surgery: A procedure to remove the tumor and see how far it has spread through the colon.
Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the lymph node tissue under a microscope to check for cancer cells. This may be done during surgery or by endoscopic ultrasound-guided fine needle aspiration biopsy.
Complete blood count (CBC): A procedure in which a sample of blood is drawn and checked for the following:
The number of red blood cells, white blood cells, and platelets.
The amount of hemoglobin (the protein that carries oxygen) in the red blood cells.
The portion of the blood sample made up of red blood cells.
Carcinoembryonic antigen (CEA) assay: A test that measures the level of CEA in the blood. CEA is released into the bloodstream from both cancer cells and normal cells. When found in higher than normal amounts, it can be a sign of colon cancer or other conditions.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if colon cancer spreads to the lung, the cancer cells in the lung are actually colon cancer cells. The disease is metastatic colon cancer, not lung cancer.
The following stages are used for colon cancer:
Stage 0 (Carcinoma in Situ)
Stage 0 (colon carcinoma in situ). Abnormal cells are shown in the mucosa of the colon wall.
In stage 0, abnormal cells are found in the mucosa (innermost layer) of the colon wall. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I
Stage I colon cancer. Cancer has spread from the mucosa of the colon wall to the submucosa or to the muscle layer.
In stage I colon cancer, cancer has formed in the mucosa (innermost layer) of the colon wall and has spread to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the colon wall.
Stage II
Stage II colon cancer. In stage IIA, cancer has spread through the muscle layer of the colon wall to the serosa. In stage IIB, cancer has spread through the serosa but has not spread to nearby organs. In stage IIC, cancer has spread through the serosa to nearby organs.
Stage II colon cancer is divided into stages IIA, IIB, and IIC.
Stage IIA: Cancer has spread through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall.
Stage IIB: Cancer has spread through the serosa (outermost layer) of the colon wall to the tissue that lines the organs in the abdomen (visceral peritoneum).
Stage IIC: Cancer has spread through the serosa (outermost layer) of the colon wall to nearby organs.
Stage III
Stage III colon cancer is divided into stages IIIA, IIIB, and IIIC.
Stage IIIA colon cancer. Cancer has spread through the mucosa of the colon wall to the submucosa and may have spread to the muscle layer, and has spread to one to three nearby lymph nodes or tissues near the lymph nodes. OR, cancer has spread through the mucosa to the submucosa and four to six nearby lymph nodes.
In stage IIIA, cancer has spread:
through the mucosa (innermost layer) of the colon wall to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the colon wall. Cancer has spread to one to three nearby lymph nodes or cancer cells have formed in tissue near the lymph nodes; or
through the mucosa (innermost layer) of the colon wall to the submucosa (layer of tissue next to the mucosa). Cancer has spread to four to six nearby lymph nodes.
Stage IIIB colon cancer. Cancer has spread through the muscle layer of the colon wall to the serosa or has spread through the serosa but not to nearby organs; cancer has spread to one to three nearby lymph nodes or to tissues near the lymph nodes. OR, cancer has spread to the muscle layer or to the serosa, and to four to six nearby lymph nodes. OR, cancer has spread through the mucosa to the submucosa and may have spread to the muscle layer; cancer has spread to seven or more nearby lymph nodes.
In stage IIIB, cancer has spread:
through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall or has spread through the serosa to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to one to three nearby lymph nodes or cancer cells have formed in tissue near the lymph nodes; or
to the muscle layer or to the serosa (outermost layer) of the colon wall. Cancer has spread to four to six nearby lymph nodes; or
through the mucosa (innermost layer) of the colon wall to the submucosa (layer of tissue next to the mucosa) or to the muscle layer of the colon wall. Cancer has spread to seven or more nearby lymph nodes.
Stage IIIC colon cancer. Cancer has spread through the serosa of the colon wall but not to nearby organs; cancer has spread to four to six nearby lymph nodes. OR, cancer has spread through the muscle layer to the serosa or has spread through the serosa but not to nearby organs; cancer has spread to seven or more nearby lymph nodes. OR, cancer has spread through the serosa to nearby organs and to one or more nearby lymph nodes or to tissues near the lymph nodes.
In stage IIIC, cancer has spread:
through the serosa (outermost layer) of the colon wall to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to four to six nearby lymph nodes; or
through the muscle layer of the colon wall to the serosa (outermost layer) of the colon wall or has spread through the serosa to the tissue that lines the organs in the abdomen (visceral peritoneum). Cancer has spread to seven or more nearby lymph nodes; or
through the serosa (outermost layer) of the colon wall to nearby organs. Cancer has spread to one or more nearby lymph nodes or cancer cells have formed in tissue near the lymph nodes.
Stage IV
Stage IV colon cancer. The cancer has spread through the blood and lymph nodes to other parts of the body, such as the lung, liver, abdominal wall, or ovary (not shown).
Stage IV colon cancer is divided into stages IVA, IVB, and IVC.
Stage IVA: Cancer has spread to one area or organ that is not near the colon, such as the liver, lung, ovary, or a distant lymph node.
Stage IVB: Cancer has spread to more than one area or organ that is not near the colon, such as the liver, lung, ovary, or a distant lymph node.
Stage IVC: Cancer has spread to the tissue that lines the wall of the abdomen and may have spread to other areas or organs.
Colon cancer can recur (come back) after it has been treated.
The cancer may come back in the colon or in other parts of the body, such as the liver, lungs, or both.
Source: National Cancer Institute (NCI)
Additional Materials (8)
Diagram showing Dukes A bowel cancer
Diagram showing Dukes' B bowel cancer
Diagram showing Dukes' C bowel cancer
Diagram showing Dukes' D bowel cancer
Rectal Cancer - Stages
1
2
3
4
5
Dukes A Bowel Cancer Staging
Interactive by Cancer Research UK / Wikimedia Commons
Colon cancer staging
Image by Terese Winslow / National Cancer Institute
Colorectal Cancer Staging In Situ
Colorectal Cancer Staging Localized
Colorectal Cancer Staging Regional
Colorectal Cancer Staging Regional
1
2
3
4
Colorectal Cancer Staging
After colon cancer has been diagnosed, the next step is to perform tests to determine if the cancer has spread within the intestine or to distant parts of the body. This is called staging. Staging helps the doctor to decide the most appropriate treatment for the cancer at its current stage. Regional means the cancer has spread to nearby lymph nodes or tissues, often through the hepatic portal system.
Interactive by TheVisualMD
Colon cancer staging
Colon cancer staging
Colon cancer staging
Colon cancer staging
1
2
3
4
Stages of Colorectal Cancer
Interactive by TheVisualMD
Stages of Colon Cancer
Video by MLive/YouTube
Colon cancer: Essential facts
Video by Institute for Cancer Genetics and Informatics/YouTube
The Staging and Grading of Cancer
Video by Learn Oncology/YouTube
Metastasis: How Cancer Spreads
Video by National Cancer Institute/YouTube
Dukes A Bowel Cancer Staging
Cancer Research UK / Wikimedia Commons
Colon cancer staging
Terese Winslow / National Cancer Institute
Colorectal Cancer Staging
TheVisualMD
Stages of Colorectal Cancer
TheVisualMD
0:53
Stages of Colon Cancer
MLive/YouTube
2:49
Colon cancer: Essential facts
Institute for Cancer Genetics and Informatics/YouTube
5:40
The Staging and Grading of Cancer
Learn Oncology/YouTube
1:49
Metastasis: How Cancer Spreads
National Cancer Institute/YouTube
Treatment
Treating Colorectal Cancer
Image by TheVisualMD
Treating Colorectal Cancer
There are three main treatment options for colorectal cancer:
Image by TheVisualMD
What Are the Treatment Options for Colon Cancer?
There are different types of treatment for patients with colon cancer.
Different types of treatment are available for patients with colon cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Seven types of standard treatment are used:
Surgery
Surgery (removing the cancer in an operation) is the most common treatment for all stages of colon cancer. A doctor may remove the cancer using one of the following types of surgery:
Local excision: If the cancer is found at a very early stage, the doctor may remove it without cutting through the abdominal wall. Instead, the doctor may put a tube with a cutting tool through the rectum into the colon and cut the cancer out. This is called a local excision. If the cancer is found in a polyp (a small bulging area of tissue), the operation is called a polypectomy.
Resection of the colon with anastomosis: If the cancer is larger, the doctor will perform a partial colectomy (removing the cancer and a small amount of healthy tissue around it). The doctor may then perform an anastomosis (sewing the healthy parts of the colon together). The doctor will also usually remove lymph nodes near the colon and examine them under a microscope to see whether they contain cancer.
Resection of the colon with anastomosis. Part of the colon containing the cancer and nearby healthy tissue is removed, and then the cut ends of the colon are joined.
Resection of the colon with colostomy: If the doctor is not able to sew the 2 ends of the colon back together, a stoma (an opening) is made on the outside of the body for waste to pass through. This procedure is called a colostomy. A bag is placed around the stoma to collect the waste. Sometimes the colostomy is needed only until the lower colon has healed, and then it can be reversed. If the doctor needs to remove the entire lower colon, however, the colostomy may be permanent.Colon cancer surgery with colostomy. Part of the colon containing the cancer and nearby healthy tissue is removed, a stoma is created, and a colostomy bag is attached to the stoma.
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiofrequency ablation
Radiofrequency ablation is the use of a special probe with tiny electrodes that kill cancer cells. Sometimes the probe is inserted directly through the skin and only local anesthesia is needed. In other cases, the probe is inserted through an incision in the abdomen. This is done in the hospital with general anesthesia.
Cryosurgery
Cryosurgery is a treatment that uses an instrument to freeze and destroy abnormal tissue. This type of treatment is also called cryotherapy.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).
Chemoembolization of the hepatic artery may be used to treat cancer that has spread to the liver. This involves blocking the hepatic artery (the main artery that supplies blood to the liver) and injecting anticancer drugs between the blockage and the liver. The liver’s arteries then deliver the drugs throughout the liver. Only a small amount of the drug reaches other parts of the body. The blockage may be temporary or permanent, depending on what is used to block the artery. The liver continues to receive some blood from the hepatic portal vein, which carries blood from the stomach and intestine.
The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
External radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer.
Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is used as palliative therapy to relieve symptoms and improve quality of life.
Targeted therapy
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do.
Types of targeted therapies used in the treatment of colon cancer include the following:
Monoclonal antibodies: Monoclonal antibodies are immune system proteins made in the laboratory to treat many diseases, including cancer. As a cancer treatment, these antibodies can attach to a specific target on cancer cells or other cells that may help cancer cells grow. The antibodies are able to then kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.
There are different types of monoclonal antibody therapy:
Vascular endothelial growth factor (VEGF) inhibitor therapy: Cancer cells make a substance called VEGF, which causes new blood vessels to form (angiogenesis) and helps the cancer grow. VEGF inhibitors block VEGF and stop new blood vessels from forming. This may kill cancer cells because they need new blood vessels to grow. Bevacizumab and ramucirumab are VEGF inhibitors and angiogenesis inhibitors.
Epidermal growth factor receptor (EGFR) inhibitor therapy: EGFRs are proteins found on the surface of certain cells, including cancer cells. Epidermal growth factor attaches to the EGFR on the surface of the cell and causes the cells to grow and divide. EGFR inhibitors block the receptor and stop the epidermal growth factor from attaching to the cancer cell. This stops the cancer cell from growing and dividing. Cetuximab and panitumumab are EGFR inhibitors.
Angiogenesis inhibitors: Angiogenesis inhibitors stop the growth of new blood vessels that tumors need to grow.
Ziv-aflibercept is a vascular endothelial growth factor trap that blocks an enzyme needed for the growth of new blood vessels in tumors.
Regorafenib is used to treat colorectal cancer that has spread to other parts of the body and has not gotten better with other treatment. It blocks the action of certain proteins, including vascular endothelial growth factor. This may help keep cancer cells from growing and may kill them. It may also prevent the growth of new blood vessels that tumors need to grow.
Protein kinase inhibitor therapy: This treatment blocks a protein needed for cancer cells to divide. Protein kinase inhibitors include:
BRAF inhibitors that block the activity of proteins made by mutant BRAF genes. Encorafenib is a BRAF inhibitor.
Immunotherapy
Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This cancer treatment is a type of biologic therapy.
Immune checkpoint inhibitor therapy: Immune checkpoint inhibitors block proteins called checkpoints that are made by some types of immune system cells, such as T cells, and some cancer cells. These checkpoints help keep immune responses from being too strong and sometimes can keep T cells from killing cancer cells. When these checkpoints are blocked, T cells can kill cancer cells better. They are used to treat some patients with metastatic colorectal cancer.
There are two types of immune checkpoint inhibitor therapy:
CTLA-4 inhibitor therapy: CTLA-4 is a protein on the surface of T cells that helps keep the body’s immune responses in check. When CTLA-4 attaches to another protein called B7 on a cancer cell, it stops the T cell from killing the cancer cell. CTLA-4 inhibitors attach to CTLA-4 and allow the T cells to kill cancer cells. Ipilimumab is a type of CTLA-4 inhibitor.Immune checkpoint inhibitor. Checkpoint proteins, such as B7-1/B7-2 on antigen-presenting cells (APC) and CTLA-4 on T cells, help keep the body’s immune responses in check. When the T-cell receptor (TCR) binds to antigen and major histocompatibility complex (MHC) proteins on the APC and CD28 binds to B7-1/B7-2 on the APC, the T cell can be activated. However, the binding of B7-1/B7-2 to CTLA-4 keeps the T cells in the inactive state so they are not able to kill tumor cells in the body (left panel). Blocking the binding of B7-1/B7-2 to CTLA-4 with an immune checkpoint inhibitor (anti-CTLA-4 antibody) allows the T cells to be active and to kill tumor cells (right panel).
PD-1 and PD-L1 inhibitor therapy: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. PD-L1 is a protein found on some types of cancer cells. When PD-1 attaches to PD-L1, it stops the T cell from killing the cancer cell. PD-1 and PD-L1 inhibitors keep PD-1 and PD-L1 proteins from attaching to each other. This allows the T cells to kill cancer cells. Pembrolizumab and nivolumab are types of PD-1 inhibitors.
Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).
New types of treatment are being tested in clinical trials.
Information about clinical trials is available from the NCI website.
Treatment for colon cancer may cause side effects.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Source: National Cancer Institute (NCI)
Additional Materials (12)
Bowel removed with a right hemicolectomy
Diagram showing the part of the bowel removed with a right hemicolectomy.
Image by Cancer Research UK / Wikimedia Commons
Colon Cancer Treatment
Video by Stanford Health Care/YouTube
This browser does not support the video element.
Treating Colon Cancer
This animation explains how colon cancer forms and how it can be treated through chemotherapy and surgery.
Video by TheVisualMD
What Types of Colostomy Bags are Used after Colon Cancer Surgery?
Video by Colon Cancer Answers/YouTube
Cancer - Causes and treatment of cancer
Video by Healthchanneltv / cherishyourhealthtv/YouTube
Cancer: Bevacizumab (Avastin)
Video by Bowel Cancer Australia/YouTube
Cancer: Capecitabine (Xeloda)
Video by Bowel Cancer Australia/YouTube
Cancer: Cetuximab (Erbitux)
Video by Bowel Cancer Australia/YouTube
Anastomosis of the Colon
Anastomose de colon - cancer du colon
Source: http://visualsonline.cancer.gov/
Image by US gov/Wikimedia
Diagram showing the part of the bowel removed with a left hemicolectomy.
Diagram showing the part of the bowel removed with a left hemicolectomy.
Image by Cancer Research UK / Wikimedia Commons
Diagram showing a local resection of an early stage bowel cancer
Diagram showing a local resection of an early stage bowel cancer.
Image by Cancer Research UK/Wikimedia
Key Facts To Know About Colostomy
Knowing that you will have to have a colostomy may be distressing. You will be concerned about its impact on your daily life. You will also be wary of how other people will feel about you. You may also think if you can get back to a healthy and active life.
First off, you have to get the correct information. First, you have to understand your digestive system. The digestive tract starts from your mouth and then moves to your stomach, small intestine, large intestine, and anus.
What is a colostomy?
A colostomy is a surgically created opening in your abdomen to allow the evacuation of waste materials after your lower bowel fails to perform its function. The healthy part of the colon is rerouted to an opening in the abdomen called a stoma.
When you have a colostomy, you have to wear an ostomy bag along with other ostomy supplies over your stoma to manage your waste evacuations. The bag adheres to the skin around the stoma with an adhesive-laden skin barrier. Due to its discreet profile, this bag remains concealed under the clothes.
Why might you need a colostomy?
You might need a colostomy when you have a problem with your digestive tract. This problem may affect your natural bowel movements. The surgeon will decide to disconnect the diseased part of the bowel from the remaining bowel and bring the active end out through a hole in the abdomen to create a stoma.
You may need a colostomy for the following reasons.
• The surgeon had to remove a part of your colon due to an underlying condition, such as colon cancer.
• Part of your bowel has to rest and heal before it regains its ability to support bowel movements.
• You have an inflammatory disorder known as inflammatory bowel disease.
• There is a blockage in your bowel.
Surgical procedure - Is a colostomy permanent?
You will need a temporary colostomy if a part of your bowel needs to rest and heal. After you get rid of that disease, you will have to undergo another surgical procedure to reverse the stoma.
A colostomy is permanent if it is a part of the treatment of a severe bowel condition. The doctor will remove the part of the bowel with irreversible damage.
Before surgery, you will meet with your doctor and ostomy care nurse. The doctor will run some lab tests and check you physically to make sure that you are fit enough to undergo surgery. You will need to avoid eating and drinking anything after midnight before surgery.
The surgeon will administer general anesthesia before surgery. That will put you to sleep for the entire duration of surgery.
During surgery, the surgeon will perform a colectomy, a procedure of disconnecting the diseased part of the colon from the healthy segment. After that, he will bring out a part of the healthy colon through a small cut in the abdomen to create a stoma. After creating this bowel diversion, he will use stitches to close the incision.
Recovery and effects of life
The overall recovery takes six to eight weeks. The first few days of recovery are critical. During this time, you will have to stay in the hospital. Once the surgical staff is sure that you are on the correct recovery track, you will be allowed to go home.
At home, you will have to rest more and eat a restricted diet. You will also need to avoid any strenuous activities until your bowel heals. Once your recovery period is over, you can eat anything you want and engage in any physical activity you like.
Image by MarleneBustos232/Wikimedia
Bowel removed with a right hemicolectomy
Cancer Research UK / Wikimedia Commons
4:26
Colon Cancer Treatment
Stanford Health Care/YouTube
3:45
Treating Colon Cancer
TheVisualMD
1:07
What Types of Colostomy Bags are Used after Colon Cancer Surgery?
Colon Cancer Answers/YouTube
2:12
Cancer - Causes and treatment of cancer
Healthchanneltv / cherishyourhealthtv/YouTube
5:38
Cancer: Bevacizumab (Avastin)
Bowel Cancer Australia/YouTube
3:38
Cancer: Capecitabine (Xeloda)
Bowel Cancer Australia/YouTube
6:47
Cancer: Cetuximab (Erbitux)
Bowel Cancer Australia/YouTube
Anastomosis of the Colon
US gov/Wikimedia
Diagram showing the part of the bowel removed with a left hemicolectomy.
Cancer Research UK / Wikimedia Commons
Diagram showing a local resection of an early stage bowel cancer
Three-panel drawing showing rectal cancer surgery with anastomosis; the first panel shows area of rectum with cancer, the middle panel shows cancer and nearby tissue removed, and the last panel shows the colon and anus joined.
Resection of the rectum with anastomosis. The rectum and part of the colon are removed, and then the colon and anus are joined.
Treatment of stage 0 (carcinoma in situ) may include the following types of surgery:
Local excision or simple polypectomy.
Resection and anastomosis. This is done when the tumor is too large to remove by local excision.
Treatment of Stage I Colon Cancer
Treatment of stage I colon cancer usually includes the following:
Resection and anastomosis.
Treatment of Stage II Colon Cancer
Treatment of stage II colon cancer may include the following:
Resection and anastomosis.
Treatment of Stage III Colon Cancer
Treatment of stage III colon cancer may include the following:
Resection and anastomosis which may be followed by chemotherapy.
Clinical trials of new chemotherapy regimens after surgery.
Treatment of Stage IV and Recurrent Colon Cancer
Treatment of stage IV and recurrent colon cancer may include the following:
Local excision for tumors that have recurred.
Resection with or without anastomosis.
Surgery to remove parts of other organs, such as the liver, lungs, and ovaries, where the cancer may have recurred or spread. Treatment of cancer that has spread to the liver may also include the following:
Chemotherapy given before surgery to shrink the tumor, after surgery, or both before and after.
Radiofrequency ablation or cryosurgery, for patients who cannot have surgery.
Chemoembolization of the hepatic artery.
Radiation therapy or chemotherapy may be offered to some patients as palliative therapy to relieve symptoms and improve quality of life.
Chemotherapy and/or targeted therapy with a monoclonal antibody or an angiogenesis inhibitor.
Targeted therapy with a protein kinase inhibitor and a monoclonal antibody in patients with a certain change in the BRAF gene.
Immunotherapy.
Clinical trials of chemotherapy and/or targeted therapy.
Source: National Cancer Institute (NCI)
Additional Materials (10)
3D Visualization of colon and rectum
Image by TheVisualMD
Colectomy Treatment for Colorectal Cancer
Treating Colorectal Cancer with Surgery
Colostomy Treatment for Colorectal Cancer
1
2
3
Colectomy Treatment for Colorectal Cancer
In late Stage I and in Stage II and III cancer, the cancerous part of the colon is removed surgically. The surgeon may perform a resection, consisting of a partial colectomy (removing the cancer and a small amount of healthy tissue around it) and an anastomosis (sewing the parts of the colon back together). Nearby lymph nodes may also be removed and biopsied.
Interactive by TheVisualMD
Detecting Colon Cancer Recurrence
Image by TheVisualMD
Treating Cancer
Because cancers differ from one another in many ways, and because each patient is unique, there isn`t just one approach to treatment. Cancer treatment aims to eliminate the primary tumor, prevent the recurrence or spread of the cancer, and relieve symptoms. Types of cancer treatment include surgery; radiation therapy, which targets specific cancer cells; chemotherapy, which targets cancer cells throughout the body; and biological therapy, which works with the body`s own immune system. If you have cancer, it`s important to educate yourself about the type of cancer you have and the options for its treatment so that you can make informed decisions.
Image by TheVisualMD
Understanding Colon Cancer Treatment Options
Video by Roswell Park Comprehensive Cancer Center/YouTube
This browser does not support the video element.
Treating Colon Cancer
This animation explains how colon cancer forms and how it can be treated through chemotherapy and surgery.
Video by TheVisualMD
Groundbreaking Treatment Gives New Hope To Colon Cancer Patients
Video by TODAY/YouTube
Bowel Resection Illustration
Line drawing showing bowel resection for colon cancer.
Image by National Cancer Institute / Unknown Illustrator
Sensitive content
This media may include sensitive content
Rectal Cancer - Stages
The T stages of bowel cancer.
Image by Cancer Research UK / Wikimedia Commons
Colon Anatomy and Function
The colon and rectum are part of the digestive system, together with other organs that help the body break down and absorb the nutrients from food. Food travels down the esophagus into the stomach, where large food molecules are broken down into smaller, usable molecules by digestive juices and emptied into the small intestine. There, food is further digested and nutrients are absorbed into the bloodstream through the intestinal wall. The digested matter is pushed into the large intestine, which absorbs water and expels solid waste material as feces.
Image by TheVisualMD
3D Visualization of colon and rectum
TheVisualMD
Colectomy Treatment for Colorectal Cancer
TheVisualMD
Detecting Colon Cancer Recurrence
TheVisualMD
Treating Cancer
TheVisualMD
2:28
Understanding Colon Cancer Treatment Options
Roswell Park Comprehensive Cancer Center/YouTube
3:45
Treating Colon Cancer
TheVisualMD
4:40
Groundbreaking Treatment Gives New Hope To Colon Cancer Patients
TODAY/YouTube
Bowel Resection Illustration
National Cancer Institute / Unknown Illustrator
Sensitive content
This media may include sensitive content
Rectal Cancer - Stages
Cancer Research UK / Wikimedia Commons
Colon Anatomy and Function
TheVisualMD
Prognosis
When colorectal cancer is caught early, it is 90% treatable
Image by StoryMD
When colorectal cancer is caught early, it is 90% treatable
Colorectal cancer is a cancer that affects the colon (large bowel) or the rectum (last 6 inches of the colon) or both. It is the 4th leading cause of death in the world which mainly affects individuals, both males and females, over the age of 50. Remember, it is always good to discuss your risk of colorectal cancer with your health care provider. Together you can decide on a screening routine that works best for you.
Image by StoryMD
What Is the Prognosis for Colon Cancer?
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis and treatment options depend on the following:
The stage of the cancer (whether the cancer is in the inner lining of the colon only or has spread through the colon wall, or has spread to lymph nodes or other places in the body).
Whether the cancer has blocked or made a hole in the colon.
Whether there are any cancer cells left after surgery.
Whether the cancer has recurred.
The patient’s general health.
The prognosis also depends on the blood levels of carcinoembryonic antigen (CEA) before treatment begins. CEA is a substance in the blood that may be increased when cancer is present.
Source: National Cancer Institute (NCI)
Additional Materials (9)
Colon cancer - Stage I Stage II Stage III
Image by Smart Servier
Digestive system - Colon cancer
Colon cancer
Image by Laboratoires Servier/Wikimedia
Colon Anatomy and Function
The colon and rectum are part of the digestive system, together with other organs that help the body break down and absorb the nutrients from food. Food travels down the esophagus into the stomach, where large food molecules are broken down into smaller, usable molecules by digestive juices and emptied into the small intestine. There, food is further digested and nutrients are absorbed into the bloodstream through the intestinal wall. The digested matter is pushed into the large intestine, which absorbs water and expels solid waste material as feces.
Image by TheVisualMD
Current Colon Cancer Survival Rates 2020 - Colon and Rectal Surgery, Penn State Cancer Institute 9
Video by Penn State Health/YouTube
What is the survival rate of colon cancer? | Summa Health System
Video by Summa Health/YouTube
What is the survival rate for colorectal cancer?
Video by GlobalHealth Asia Pacific/YouTube
What's the best diet strategy to prevent colon cancer
Video by Mayo Clinic/YouTube
Take Control Over Colon Cancer
Video by Hopkins Kimmel/YouTube
Patient Survived Stage 4 Colon Cancer, Twice
Video by Loma Linda University Health/YouTube
Colon cancer - Stage I Stage II Stage III
Smart Servier
Digestive system - Colon cancer
Laboratoires Servier/Wikimedia
Colon Anatomy and Function
TheVisualMD
0:27
Current Colon Cancer Survival Rates 2020 - Colon and Rectal Surgery, Penn State Cancer Institute 9
Penn State Health/YouTube
1:01
What is the survival rate of colon cancer? | Summa Health System
Summa Health/YouTube
1:25
What is the survival rate for colorectal cancer?
GlobalHealth Asia Pacific/YouTube
0:52
What's the best diet strategy to prevent colon cancer
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Colon Cancer
Colon cancer is a disease in which cancer cells form in the tissues of the colon, the longest part of the large intestine. Learn about symptoms, risk factors, tests, and treatments.