Colon cancer is one of the most common cancers. You can reduce your risk of colon cancer by regular screening. All patients age 50 and over should do regular colon cancer screening.

There are two types of colon cancer screening:

• Flexible Sigmoidoscopy “Flex Sig” – every 5 years
• Hemoccult Cards – every year (detects blood in the stool)

Probably the best test to screen for colon cancer is the flex sig. However, after discussion with your healthcare provider, you may decide to do one type of screening or both.

Flexible Sigmoidoscopy

Flexible sigmoidoscopy is a procedure that enables your physician to examine the lining of the rectum and a portion of the colon by insert5ing a flexible tube that is about the thickness of your finger into the anus and advancing it slowly into the rectum and lower part of the colon.

The rectum and lower colon must be completely empty of waste material for the procedure to be accurate and complete. Our usual preparation is to take Milk of Magnesia the day before the exam. Use clear liquids only after 4 p.m. and up until the procedure. Two “Fleet” enemas are done at home before the appointment. When you schedule your appointment our receptionist will give you more detailed instructions.

This test is usually well tolerated. There is often a feeling of pressure, bloating, or cramping at various times during the procedure. You will be lying on your side while the sigmoidoscope is advanced through the rectum and colon. As the instrument is withdrawn, the lining of the intestine is carefully examined. The procedure usually takes anywhere from 5 to 20 minutes.

If the doctor sees an area that needs evaluation in greater detail, a biopsy (sample) may be obtained and submitted to a laboratory for greater analysis. If polyps (growths from the lining of the colon that vary in size) are found they can be biopsied, but usually are not removed at the time of the sigmoidoscopy. Polyps are of varying types. Certain benign polyps, known as “adenomas” are potentially precancerous. Certain other polyps (“hyperplastic”) may not require removal. Your doctor will likely request that you have a colonoscopy (a complete examination of the colon) to remove any large polyp that is found, or any small polyp that is an adenoma after biopsy analysis.

After sigmoidoscopy, the physician will explain the results to you. You may have some mild cramping or a bloating sensation because of the air that has been passed into the colon during the examination. This will disappear quickly with the passage of gas. You should be able to eat and resume your normal activities after leaving your doctor’s office.

Flexible sigmoidoscopy and biopsy are generally safe when performed by physicians who have been specially trained and are experienced in this procedure. Possible rare complications include a perforation (tear through the bowel wall) and bleeding from the site of the biopsy.

Hemoccult Cards

Hemoccult cards require that you take 3 separate samples of your stool to be placed on special cards. These cards are then analyzed for the presence of blood. There are instructions in the cards for collection and dietary restrictions. Some medications, particularly aspirin/coumadin and anti-inflammatory medications may cause difficulties with interpreting the test. Please discuss this with your healthcare provider if you think you may be on one of these medications. If your test reveals that presence of blood, usually further testing such as a colonoscopy (a complete exam of your colon) is recommended.

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