Colon Cancer Screening (cont.)
Air contrast (double contrast barium enema)
Even though double contrast barium enema has been included in screening guidelines,
it is not as accurate as colonoscopy or, perhaps, virtual colonoscopy
in detecting small polyps or cancers. Like virtual colonoscopy, it cannot
remove polyps. Also like virtual colonoscopy, it may mistake particles of stool
for polyps. In addition, as the numbers of barium enema examinations decreases,
radiologists have less experience doing them, and their ability to do a
good examination is decreasing. For these reasons, double contrast barium
enemas are not widely used for colon cancer or polyp screening. For more information, please see the Barium Enema article.
Surveillance recommendations for individuals with higher than average risk
of colon cancer
Many individuals are at higher than average risk for developing colon cancer
because of a family history of colon cancer, history of chronic ulcerative
colitis, rare hereditary colon cancer syndromes, or a history of colon
polyps or cancer. Periodic surveillance colonoscopies are recommended for these
individuals to remove precancerous polyps, and /or to detect early cancers.
Patients with a history of colon polyps
Patients with history of colon polyps often develop polyps
subsequently. Therefore, periodic surveillance colonoscopies are recommended. In
individuals with only precancerous polyps that are completely removed, the usual
recommendation is to repeat the colonoscopy after 3 years. If the colonoscopy at
3 years shows no recurrence of polyps, then the interval between subsequent
colonoscopies is extended to 5 years.
Sometimes, doctors are not confident that all polyps have been completely
removed. Examples include individuals with multiple pre-cancerous polyps, polyps
that are technically difficulty to completely excise, or less than optimal
visualization of the colon due to inadequate cleansing of the colon. Under these
circumstances, the decision regarding the interval between
surveillance colonoscopies is best arrived at jointly between the patient and the doctor.
For more information, please see the Colon
Polyps article.
Next: Patients with history of colorectal cancer »
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