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Ask the Medical Expert Archives 2000-2004

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Alternative to Colonoscopy
October 2000

Q. Is there another way besides a colonoscopy to screen for colon cancer? Can you give me information about this procedure?

A. There are many different ways to screen for colon cancer. One way is through fecal occult blood testing. This is where you smear some stool on a card and then some liquid is dropped on the card to test for blood. By doing this yearly, you can reduce your risk of dying from colon cancer by about 33%. However, there is a very large (about 40%) false positive rate within a ten year period.

Another method is a sigmoidoscopy, which is like the colonoscopy but the tube is much shorter and the preparation is much simpler. A sigmoidoscopy every three to five years can reduce your risk of dying from colon cancer by about 40- to 50%. Another method used by some doctors is to combine both the fecal occult blood testing and the flexible sigmoidoscopy. While in theory this should be better than either one by itself, it is not clear that this is the case.

Another procedure is a barium enema. This procedure requires a preparation similar to that of a colonoscopy, but it is considerably safer than a colonoscopy (it is rare but not unheard of to have a colonoscopy puncture a hole in your intestine). By getting the barium enema every five to ten years you can reduce your risk of dying from colon cancer by about 85- or 90%. The colonoscopy is about 90- 95% effective at reducing your risk of dying from colon cancer.

You can read more about screening for colon cancer at:
http://rattler.cameron.edu/colon/screen.html
http://www.maxinet.com/mansell/polyp.htm#Screening%20for%20Colon%20Cancer

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