Bowel cancer diagnosis and tests
The NHS in England, Wales, and Northern Ireland invites men and women aged 60 – 74 to have bowel cancer screening every 2 years. In Scotland, the screening is every 2 years between 50 to 74 years of age.
Screening involves a simple at-home test that checks for blood in the stool (poo) that you may not be able to see.
The test is either a faecal occult blood test (FOB), or faecal immunochemical test (FIT).
Another test is being introduced for over 55s using a tiny camera to examine the lower bowel. This is called flexible sigmoidoscopy.
Examinations and tests
As well as routine bowel cancer screening, if you are having rectal bleeding or changes in your bowel movements, you will undergo tests to determine the cause of the symptoms.
- Your doctor will usually insert a gloved finger into your rectum through your anus.
- This test, called a digital rectal examination (DRE), is a quick screening to make sure that any bleeding is actually coming from your rectum or if there are any tumours in the rectum.
- This is not painful, but it is uncomfortable for some people. It usually takes less than a minute.
In a hospital out-patient clinic you may have a test called a colonoscopy.
- This is a test that allows a specialist to look at the inside of your colon.
- This test looks for polyps, tumours, or other abnormalities.
- Colonoscopy is an endoscopic test. This means that a thin, flexible plastic tube with a tiny camera on the end will be inserted into your colon via your anus. As the tube is advanced further into your colon, the camera sends images of the inside of your colon to a video monitor.
- Colonoscopy is an uncomfortable test for most people. You will first be given a laxative solution to drink that will clear most of the faecal matter from your bowel. You will be allowed nothing to eat before the test. Whenever possible, you will be given medication before the procedure to relax you and relieve the discomfort.
- Flexible sigmoidoscopy is similar to colonoscopy but does not go as far into the colon. It uses a shorter endoscope to examine the rectum, sigmoid (lower) colon, and most of the left colon.
Air-contrast barium enema is a type of X-ray that can show tumours.
- Before the X-ray is taken, a liquid is introduced into your colon and rectum via your anus. The liquid contains barium, which shows up solid on X-rays.
- This test highlights tumours and certain other abnormalities in the colon and rectum.
- Other types of contrast enemas are available.
- Air-contrast barium enema frequently detects malignant tumours, but it is not as effective in detecting small tumours or those far up in your colon.
If a tumour is identified in the colon or rectum, you will probably undergo a CT scan of your abdomen and a chest X-ray to make sure the disease has not spread.