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Colon cancer screening: What are the latest options?

by , 17 March 2017
Colon cancer screening: What are the latest options?
About 140,000 new cases of colorectal cancer are diagnosed every year, while about 51,000 die from this type of cancer every year. 51,000 people die of colorectal cancer every year.

What's more, research shows that if everyone followed the recommended screening for colorectal cancer, up to 60% of deaths due to colorectal cancer could be prevented! The question is: Why do so many of us avoid getting screened as often as we should?

If you've ever had a colonoscopy, you know how unpleasant they are -from the bowel prep needed to empty your colon, to the procedure itself. So while a colonoscopy is one of the most accurate ways to diagnose colorectal cancer, it's safe to say that no one who's ever had one can say that they like getting them.

Thankfully, researchers are working hard to enhance the standard colonoscopy. None of them eliminate the awkward aspects of the test (yup, I'm talking about the icky bowel prep!) but they do make the screening more accurate. “Even in expert hands, there are still significant abnormalities that are missed at times,” says Dr Durado Brooks, MD, director of prostate and colorectal cancers for the American Cancer Society

Here are four new ways to detect colorectal cancer.

Four advanced tests for colorectal cancer

#1: Endocuff
If you’ve ever had a balloon colonoscopy, it will be easy for you to understand how the Endocuff works. Very similar to this particular colonoscopy, the Endocuff is just a disposal cap instead of a balloon. 
 
The cap easily slips onto the end of the colonoscope – which is basically a long, flexible tube with a camera on the end – and helps flatten out the folds as the scope moves through the intestine. 
 
#2: Robotic colonoscopy
Robotic colonoscopies are very different to conventional ones. While conventional colonoscopies involve a doctor threading a colonoscope through the large intestine, robotic colonoscopies rely on gears to mechanically move the scope through the bowels. 
 
Of course, one benefit of conventional colonoscopies is that they allow doctors to immediately remove any suspicious looking polyps or growth. That said, this procedure is prone to human error. While it’s pretty rare, sometimes the equipment can poke a hole in the intestine.
 
According to Dr Brooks, “One of the hopes with robotic colonoscopies is to decrease pressure on the colon and decrease the possibility of perforation.” Another advantage of robotic colonoscopies? They don’t require sedation. 

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#3: Balloon colonoscopy
The way in which a balloon colonoscopy works is relatively straightforward. The colon is full of twists and turns and folds where cancers and polyps can hide. 
 
This type of colonoscopy entails using a colonoscope with an inflatable balloon on one end, which mechanically flattens these folds in the colon as the doctor moves the device up the intestine. What’s more, this type of colonoscopy allows the doctors to see a lot of the colon. The balloon colonoscope would require a patient to go under sedation.
 
#4: Full spectrum colonoscopy 
Dr Seth Gross, MD, a gastroenterologist and assistant professor of medicine at NYU Langone Medical Center in New York City in the USA, explains that conventional colonoscopies afford doctors a 170-degree view of the colon. However, the full spectrum colonoscopy, a new instrument in the works, widens that view to an impressive 330 degrees.
 
Not only is there a camera on the tip of the colonoscope; but also one on each side of it. Scientists at NYU in conjunction with an Israeli technology company developed the full spectrum colonoscope.
 

Most of these new colonoscopies are still in development and evaluation phase

“None have been proven to be more effective than simply a diligent and attentive colonoscopy,” says Dr Brooks. “The good news is that colonoscopy if it is performed in a careful, thoughtful manner is a very effective tool not only to find cancer but also precancerous lesions and remove them to prevent cancer from occurring.
 
Dr Brooks adds that there are a number of colonoscopy alternatives that are just as effective and nowhere near as invasive. Examples of such tests include a virtual colonoscopy (also called a CT scan) and a simple stool test.
 
“It's great that there may be some [screening] enhancements on the horizon, but right now we've got a number of very good tests. If we just use the technology that we currently have available, we can cut both the number of cases of colorectal cancer in half as well as the number of deaths in half,” Dr Brooks concludes.

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Colorectal cancer screening should begin at age 50 for most people

If you’re wondering how often you should get screened for colorectal cancer, the short answer is that it depends on the test as well as your risk for the disease.
 
If you’re at average risk and choose colonoscopy, you should have the procedure at least once every 10 years after you turn 50. 
 
If you have a personal or family history of colorectal cancer or polyps, inflammatory bowel disease or a hereditary syndrome like familial adenomatous polyposis or hereditary nonpolyposis colorectal cancer (Lynch syndrome), you should get screened earlier and more often.

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