Attach 8a - Revised Patient Focused Intervention

Screening Test Options
Screening guidelines have been developed by several medical societies and organizations. All strongly recommend that adults aged 50 or older be screened regularly for
colorectal cancer. Several tests can be used to find polyps or colorectal cancer. Each has advantages and disadvantages. Here is information that can help you decide, with your
doctor, which test(s) is right for you:

Screening Test

How Often

Fecal Occult Blood Test (FOBT,
Hemoccult, Stool Guaiac)
Detects blood in stool from polyps, cancer,
or other causes. Before the test, you may be
asked to follow a special diet (information is
included in the test kit). During the test, you
place stool samples on special cards and
mail the cards to your doctor's office or lab.

Once a year, starting
at age 50.

Flexible Sigmoidoscopy (Flex Sig) and
Fecal Occult Blood Test (FOBT,
Hemoccult, Stool Guaiac)
Flexible Sigmoidoscopy (Flex Sig) allows
the doctor to examine the lining of the
rectum and lower colon, using a thin,
flexible, lighted tube. To prepare, you use a
strong laxative, as prescribed by your
doctor, to clean out your colon and rectum.
The test is done at a doctor's office or a
specialty clinic.

Flex Sig every 5
years and FOBT
(Hemoccult, Stool
Guaiac) every 3
years, starting at
age 50.

Colonoscopy
Allows the doctor to examine the lining of
the rectum and the entire colon, using a thin,
flexible, lighted tube. To prepare, you use a
strong laxative, as prescribed by your
doctor, to clean out your colon and rectum.
During the test, you are given medication to
help you relax. Colonoscopy is done at a
specialty clinic.

Once every 10 years
starting at age 50.

(Colonoscopy is usually recommended as a
follow-up test if any of the other screening
tests are abnormal.)

Important Points to Consider
You will receive the test kit from your doctor or nurse
You do the test yourself at home, and you do not need to miss work
Before the test, your doctor may recommend that you avoid some foods and medicines
You will not feel discomfort during or after the test
There are no complications
This test may miss some polyps and cancers
If blood is found, you will need a follow-up exam - usually with a colonoscopy
The combination of flex sig and FOBT may increase the chance of finding polyps and early cancers
For Flex Sig:
You will visit a doctor's office and if you work, you will have to miss half a day
Before the test, your doctor will recommend that you restrict your diet and use strong laxatives and/or enemas
You will be able to drive yourself home after the test
You may feel discomfort during or after the exam
There is a very slight risk of perforation of the colon, reaction to the medication, or bleeding
This test provides a direct view of the rectum and lower colon where half of colorectal cancer occurs, but cannot view
the entire colon
If polyps or lesions are found, you will need a follow-up exam - usually with a colonoscopy
You will visit a specialty clinic and if you work, you will have to miss a day
Before the test, your doctor will recommend that you restrict your diet and use strong laxatives and/or enemas
You will be given medication (sedation) to help you relax
Someone will have to drive you home after the test
You may feel discomfort during or after the exam
There is a slight risk of perforation of the colon, reaction to medication, and bleeding
This test provides a direct view of the rectum and the entire colon
Some doctors believe that this is the most accurate test for finding polyps and cancers
If polyps or lesions are found, they can often be removed during the procedure

Colorectal Cancer Screening Facts
What is Colorectal Cancer?
Colorectal cancer is cancer that
develops in the colon or
rectum. It is the second leading
cancer killer in the U.S., but it
doesn't have to be. If everyone
aged 50 and older had regular
colorectal cancer screening
tests, more than one third of
deaths from this cancer could
be avoided.

PBS

S o u r ce : C D C

Colorectal Cancer Facts and Figures
Both men and women are at risk
93% of cases occur in people aged 50 and older
The risk of developing colorectal cancer
increases with age
How Screening Saves Lives
Colorectal cancer almost always develops
from precancerous polyps (abnormal
growths) in the colon or rectum. Screening
tests can find polyps, so they can be
removed before they turn into cancer.
Screening tests can also find colorectal
cancer early, when treatment works best.

When Should I Begin Screening?
You should begin screening for colorectal cancer when
you turn 50, then continue at regular intervals. However,
you may need to be tested earlier or more often than other
people if:
You or a close relative have had colorectal polyps or
colorectal cancer, or
You have inflammatory bowel disease.
Talk with your doctor about when you should begin
screening and how often you should be screened.
Does Colorectal Cancer Have Symptoms?
Polyps and colorectal cancer often do not cause
symptoms, especially at first. But sometimes there are
symptoms, such as:
Blood in or on your stool;
Unexplained and frequent pain, aches, or cramps in
your stomach;
A change in bowel habits, such as having stools that
are narrower than usual; and
Unexplained weight loss.
If you have any of these symptoms, talk to your doctor.
These symptoms may also be caused by something other
than cancer, but the only way to know what is causing
them is to see your doctor.
Screening Tests for Colorectal Cancer
Below is a list of several tests that are available to screen
for colorectal cancer. Some are used alone, while others
are used in combination with each other. Research
evidence shows that all of these tests save lives. Talk with
your doctor about which screening test is best for you.
Fecal Occult Blood Test (FOBT, Hemoccult,
Stool Guaiac)
This test checks for occult (hidden) blood in the stool.
You receive a test kit from your doctor. You may be asked
to follow a special diet before and during the test.

At home, you place a small amount of your stool from
three bowel movements in a row on test cards. You return
the cards to your doctor's office or lab, where the stool
samples are checked for hidden blood.
Combination of Flexible Sigmoidoscopy and Fecal
Occult Blood Test (FOBT, Hemoccult, Stool Guaiac)
Flexible Sigmoidoscopy allows the doctor to examine the
lining of your rectum and lower part of your colon using a
thin, flexible, lighted tube called a sigmoidoscope. The
tube is inserted into your rectum and lower part of the
colon. During the exam, the doctor can find and remove
polyps within reach of the sigmoidoscope. This test is
done at a doctor’s office or a specialty clinic.
Combining both tests may increase the chance of finding
polyps and cancers.
Colonoscopy
This is similar to flexible sigmoidoscopy, except this test
allows the doctor to examine the lining of your rectum and
the entire colon using a thin, flexible, lighted tube called a
colonoscope. The tube is inserted into your rectum and
colon. During the exam, the doctor can find and remove
most polyps and some cancers in the entire colon and
rectum. This test is done at a specialty clinic.
The Bottom Line
If you are 50 or older, get screened regularly for colorectal
cancer. Talk to your doctor about the best screening
method for you.
For more information, visit www.cdc.gov/cancer/
ScreenforLife or call the National Cancer Institute's
Cancer Information Service: 1-800-4-CANCER. For
TTY, call 1-800-332-8615.
(See reverse side for information on screening tests )