Colorectal Cancer Screening

When patients of the Harris Health System have a positive FIT result, they are referred to a gastroenterologist for a colonoscopy. To help patients understand how to properly prepare for the procedure, the Community Network for Cancer Prevention collaborated with clinical staff of the HHS to develop colonoscopy instruction guides.

Funding for the development and distribution of the colonoscopy instruction guides was provided by the Walmart Foundation and the American Cancer Society. The purpose of the instructional guides is to:

• Increase the proportion of patients who return their fecal immunochemical test to the HHS laboratory staff.
• Increase the proportion of patients who receive a follow-up diagnostic colonoscopy after a positive fecal immunochemical test.
• Increase the proportion of patients diagnosed with CRC in precancerous or early stages of disease.

The printed colonoscopy instructional guide is a set of easy-to-read instructions that is given to HHS patients when they are scheduled to undergo a colonoscopy. The guide is written in English, Spanish, and Vietnamese and is designed to help patients properly prepare for the procedure. It explains dietary and drug restrictions, when special medicines required before the test should be taken, what to expect during the procedure, how long the procedure will take, and any physical restrictions after the procedure.

View the guide in English, Spanish, and Vietnamese.

The best way to prevent colorectal cancer is to be screened regularly for the disease. Screening tests for colorectal cancer include the fecal immunochemical test (FIT), flexible sigmoidoscopy, and colonoscopy.

Several risk factors may increase the chance of getting colorectal cancer in both men and women, including:

• Age (typically 50 years of age and older)
• Family history of colorectal cancer
• Race/ethnic background (African Americans and people of Jewish dissent have the highest risk)
• Diets high in red meats and processed meats
• Physical inactivity
• Obesity
• Smoking
• Heavy alcohol use
• Type 2 diabetes
• Intestinal disease (familial adenomatous polyposis, hereditary nonpolyposis colon cancer, chronic ulcerative colitis, and Crohn’s disease)
• Hereditary colon cancer syndromes (familiar adenomatous polyposis, Lynch Syndrome)

The fecal immunochemical test, also known as FIT, is used to screen for colorectal cancer. The FIT is performed the same way as the traditional fecal occult blood test without the need to follow a special diet or use special drugs in preparation for the test. Like the FOBT, the FIT detects small amounts of blood in feces, which might be a sign of a polyp or cancer. When performed annually, beginning at age 50, FIT allows physicians to track patients at high risk for CRC.

For additional information on the FIT, visit the American Cancer Society website.

Men and women who are 50 years of age and older should have the FIT each year. The FIT checks for blood in the stool, which may be a sign of cancer. This test may be done privately at home. If blood is found in the stool, additional exams may be required, such as a colonoscopy.

The fecal occult blood test, also known as FOBT, can also determine whether blood is in a patient’s stool by testing a stool specimen for colorectal cancer. The FOBT detects small amounts of blood in feces. When performed annually, beginning at age 50, FOBT allows physicians to track patients at high risk for CRC. Patients will have to follow a special diet and avoid taking certain drugs when taking the FOBT as they may affect test results. Some of the food and drugs that the doctor may recommend to avoid are:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), naproxen (Aleve), or aspirin (more than one adult aspirin per day), for seven days before testing.
• Vitamin C in excess of 250 mg daily from either supplements or citrus fruits and juices for three days before testing.
• Red meats (beef, lamb, or liver) for three days before testing.

The fecal occult blood test, also known as FOBT, can also determine whether blood is in a patient’s stool by testing a stool specimen for colorectal cancer. The FOBT detects small amounts of blood in feces. When performed annually, beginning at age 50, FOBT allows physicians to track patients at high risk for CRC. Patients will have to follow a special diet and avoid taking certain drugs when taking the FOBT as they may affect test results. Some of the food and drugs that the doctor may recommend to avoid are:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil), naproxen (Aleve), or aspirin (more than one adult aspirin per day), for seven days before testing.
• Vitamin C in excess of 250 mg daily from either supplements or citrus fruits and juices for three days before testing.
• Red meats (beef, lamb, or liver) for three days before testing.

Men and women who are 50 years of age and older should have the FOBT each year. The FOBT checks for blood in the stool, which may be a sign of cancer. This test may be done privately at home. If blood is found in the stool, additional exams may be required, such as a colonoscopy.

The FOBT does not detect polyps (abnormal growths) in the colon. Patients with certain risk factors may need to have a more invasive test, such as colonoscopy.

For additional information on the FOBT, visit the American Cancer Society website.

A colonoscopy is a screening test that uses a scope to examine the inside of the entire colon and rectum for abnormal growths (polyps). This procedure requires that patients follow dietary and medication restrictions to be accurate. The aim of the test is to remove precancerous polyps before they develop into colorectal cancer.

For additional information on colonoscopy, visit the American Cancer Society website.

Based on the recommendations of the American Cancer Society:

Men and women 45 years of age and older who are at average risk of colorectal cancer should have a colonoscopy once every 10 years. Men and women with a family history of colorectal cancer and should first be screened at age 40 (or at an age that is 10 years younger than the age at which the youngest immediate family member was diagnosed with the disease) and should be screened more often.

Individuals who have certain intestinal diseases (ulcerative colitis, and Crohn’s disease) inheritable colon cancer syndromes (familial adenomatous polyposis and Lynch syndrome) and are at high risk of colorectal cancer should begin screening at even younger ages.

Men and women who have had polyps or other precancerous tissues removed and those who have had colorectal cancer should only be screened with colonoscopy.