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Colon Cancer: Tests

Cancer that forms in the tissues of the colon (the longest part of the large intestine).

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

Tests for Colon Cancer

Tests that examine the colon and rectum are used to detect (find) and diagnose colon cancer.

The following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
  • Digital rectal exam: An exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the rectum to feel for lumps or anything else that seems unusual.
  • Fecal occult blood test: A test to check stool (solid waste) for blood that can only be seen with a microscope. Small samples of stool are placed on special cards and returned to the doctor or laboratory for testing...

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What works? Research summarized

Evidence reviews

Venous Thromboembolism: Reducing the Risk of Venous Thromboembolism (Deep Vein Thrombosis and Pulmonary Embolism) in Patients Admitted to Hospital

Venous thromboembolism (VTE) is a term used to include the formation of a blood clot (a thrombus) in a vein which may dislodge from its site of origin to travel in the blood, a phenomenon called embolism. A thrombus most commonly occurs in the deep veins of the legs; this is called deep vein thrombosis. A dislodged thrombus that travels to the lungs is known as a pulmonary embolism.

Diagnostic performance of chromoendoscopy and narrow band imaging for colonic neoplasms: a meta-analysis

The review concluded that chromoendoscopy and narrow band imaging had similar diagnostic performance for assessing colonic neoplasms, but both gave unacceptably high false positive rates. These conclusions reflect the data presented, but should be interpreted cautiously due to limitations in study selection, quality assessment and analysis.

DNA Mismatch Repair Deficiency Tumour Testing for Patients With Colorectal Cancer: A Health Technology Assessment [Internet]

Testing tumours for deficient DNA mismatch repair (dMMR) has been identified as a practice that is potentially over-utilized. According to clinical experts, dMMR tumour testing appears to be transitioning from an approach aimed at identifying patients and families with Lynch syndrome (LS) into a tumour phenotyping procedure that can be used to predict the prognosis of colorectal cancer (CRC) and to guide for adjuvant chemotherapy decisions. The use of a test with a prognostic and predictive value falls under the realm of “personalized medicine.” According to oncology and pathology experts, this recent application of dMMR tumour testing is the major driver of new test requisitions. This transition has led to an increased demand for the test, with unclear benefits for the patient or family members. In general, there is a lack of clarity regarding when the tests should be ordered and the impact of tumour dMMR status on CRC outcomes in the current era of oxaliplatin- and irinotecan-based chemotherapy. The central question, however, is whether universal dMMR tumour testing of CRC tumours is a viable and desirable option, given the known limitations of LS pre-selection criteria based on age, history, and pathology, and recognizing the potential utility of tumour dMMR status for personalizing cancer therapy. Missed cases of LS resulting from a targeted tumour dMMR testing strategy that is restricted to pre-selected high-risk individuals (e.g., selected based on the rBG) can be problematic and costly for the system, which would potentially support broader (universal) dMMR tumour testing of all CRC tumours. Alternatively, universal tumour testing carries with it additional costs associated with testing all CRC patients, most of whom will not have LS.

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Summaries for consumers

Colon Cancer Treatment (PDQ®): Patient Version

Expert-reviewed information summary about the treatment of colon cancer.

Bowel cancer: Sigmoidoscopy and colonoscopy

In a colonoscopy, the entire large intestine is examined for bowel polyps and areas of abnormal tissue. These can then be removed straight away during the procedure. Sigmoidoscopy is similar, but only involves part of the large intestine.In Germany, bowel cancer screening is intended for people between the ages of 50 and 75 without any particular risk factors for bowel cancer. The costs of guaiac fecal occult blood tests and colonoscopies are covered by statutory health insurance in Germany.Sigmoidoscopy is not offered as part of bowel cancer screening and also not covered by statutory insurance funds for this purpose. But studies have shown that sigmoidoscopy screening can indeed lower the risk of getting bowel cancer or dying of it. These studies also help to get an idea of the benefits of colonoscopies.

Stomach (Gastric) Cancer Screening (PDQ®): Patient Version

Expert-reviewed information summary about tests used to detect or screen for stomach (gastric) cancer.

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Terms to know

Barium Enema
A procedure in which a liquid that contains barium sulfate is put through the anus into the rectum and colon. Barium sulfate is a silver-white metallic compound that helps show pictures of the colon, rectum, and anus on an x-ray.
Colon (Bowel)
The longest part of the large intestine, which is a tube-like organ connected to the small intestine at one end and the anus at the other. The colon removes water and some nutrients and electrolytes from partially digested food. The remaining material, solid waste called stool, moves through the colon to the rectum and leaves the body through the anus.
A test to look into the rectum and colon that uses a long, flexible, narrow tube with a light and tiny camera on the end. The tube is called a colonoscope.
The last several inches of the large intestine closest to the anus.
Examination of the lower colon using a sigmoidoscope, inserted into the rectum. A sigmoidoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue to be checked under a microscope for signs of disease. Also called proctosigmoidoscopy.

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Other terms to know: See all 5
Barium Enema, Colon (Bowel), Colonoscopy

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