Colorectal cancer is a malignant tumor that occurs in the colon or the rectum. In most people, colorectal cancer develops slowly over several years. It starts as a growth of tissue in the inner lining of the colon or rectum. This growth is called a polyp. Most polyps are benign, non-cancerous tumors. However, some polyps can change slowly over a period of 10-15 years to become cancer.
Colorectal cancer may also develop from abnormal cells in the lining of the colon or rectum. These abnormal cells are called dysplasia. These are not polyps but groups of cells that are not normal. This type of colorectal cancer is more common in people with diseases of the bowel.
Often, there are no obvious signs but they can include:
If you have any of these symptoms, please see your doctor immediately and ask about testing for colorectal cancer.
Screening is the process of looking for cancer in people who have no symptoms of the disease. Screening for colorectal cancer means looking for polyps or bleeding in the bowel. Polyps found before they become cancerous can be removed. There are two ways to do screening for colorectal cancer: Colonoscopy and Fecal Immunochemical Test (FIT). The Health Authority of Abu Dhabi recommends colonoscopy every 10 years in individuals of average risk from 40 years of age and above for both men and women, or a FIT every two years.
Colonoscopy is a test that allows your doctor to look inside your bowel using a thin, flexible tube called a colonoscope. A small camera is attached to the tip of colonoscope so that pictures or videos of the large bowel(colon) can be taken. A colonoscopy helps find colon polyps or tumors. It can also be used to collect tissue samples and remove abnormal growths. Colonoscopy is the “gold standard” for screening for colorectal cancer.
You will be told to drink liquids for a day before the exam like plain tea or coffee with sugar but no milk. Most liquids are usually allowed unless they have red or purple food colorings, which could be mistaken for blood in the colon. Do not eat or drink anything after midnight. You will need to take laxatives the day before the test and possibly an enema in the morning. Inform you doctor of all medical conditions and any medications taken regularly.
During colonoscopy, patients will be asked to lie on their left side on an examination table. The doctor will insert a colonoscope into the anus and slowly guide it through the rectum and bowel. A camera will transmit the image from inside the bowel allowing the doctor to carefully examine the bowel lining.
No, it is not painful. In most cases, patients are given medicine to sleep through the colonoscopy, so they don’t feel anything.
Colonoscopy usually takes about 30 minutes. It may take longer if there are any polyps or abnormal cells. Test results will usually be ready within 2 weeks. Your doctor will inform you when should be tested again.
Most people feel fine after colonoscopy. You may have some gas, which could cause mild discomfort. This can be reduced by lying on your stomach.
If a small polyp is found, your doctor will probably remove it. If your doctor sees a large polyp, a tumor, or anything else abnormal, a biopsy will be done and sent to a lab to be checked for cancer or pre-cancer cells.
The Fecal Immunochemical Test (FIT) , is a newer kind of fecal test that detects hidden blood in the stool.
There are no drugs or dietary restrictions recommended before the test and sample collection is easy. Only one stool sample is required over one day. If the results are positive for hidden blood, a colonoscopy is required for further investigations. This test is simple, safe and painless. You should not use the FIT, if you are bleeding from a hemorrhoid or anal fissure or have blood in your urine. If you are a woman, you should not do the FIT during your menstrual period or in the three days after the end of your period.
Do the test after the diarrhea has stopped.
Urine has no effect on the accuracy of the test unless it has blood in it.
A positive result indicates abnormal bleeding from the lower digestive tract. This requires follow-up testing by colonoscopy which allows your doctor to look inside your colon. A positive result from a FIT does not always mean that a person has colon cancer. Likewise, a negative result of a FIT does no guarantee that a person is unaffected.