Accepted
at 5:57 a.m. Jul, 13, 2024
by
Ahmed7
Author:
cmahlen
Type of change:
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also not needed for this question, see other suggestion. question does not discuss patient with avg risk of colon cancer
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How often should patients with an average risk for colon cancer be screened if using flexible sigmoidoscopy or fecal occult blood testing (FOBT)?
- Sigmoidoscopy q{{c1::5 years}} alone or q{{c1::10 years}} with annual fecal immunohistochemical testing (FIT)
- FOBT q{{c1::annually}}
Extra
| Screening | USPSTF* | Interval | Features |
|---|---|---|---|
| Colonoscopy | Yes | Every 10 years | Detects lesions that are less than 0.5 cm in size by visualizing the entire rectum and colon. It is also able to obtain samples and remove polyps. Colonoscopy is used as a follow-up test when other tests are inconclusive. It requires anesthesia. There is 0.2% perforation risk |
| Flexible sigmoidoscopy | Yes | Every 5 years and FOBT every 3 years | Confined only to the lower third of the colon, and requires sedation. It is able to remove polyps and is used to take biopsies. If FOBT is positive, colonoscopy must be done |
| Fecal occult blood test (FOBT) | Yes | Every year | There are two modalities: -Traditional hemoccult chemical tests, which need dietary changes three days beforehand. The other is the more recent immunochemical tests, which may be performed at home but requires colonoscopy follow-up in the event of a positive result. |
| Barium enema with sigmoidoscopy | No | Every five years | As the rectum is difficult to be visualized, sigmoidoscopy is a mandatory in addition to barium enema. It only detects 50% of polyps larger than 1 cm. Sedation is not needed. Mucosal inflammation is difficult to detect. It can be helpful if colonoscopy is insufficient due to anatomical or pathologic limitations. |
| CT colonography | No | Every five years | It requires intestinal preparation, does not require sedation; it may identify incidental abnormalities (such as extracolonic neoplasms or abdominal aortic aneurysms). It is as likely as colonoscopy to detect lesions 10 mm or bigger, but may be less sensitive for smaller adenomas. It also does not allow for biopsy or polypectomy. |
| Capsule endoscopy | No | Every five years | It has low sensitivity and specificity. Unable to obtain biopsies. It is less invasive but requires more intensive bowel preparation. Unavailable for screening in the USA |
| *US Preventive Services Task Force recommendations | |||
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