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Colon and Rectal Cancer: Prior to Diagnosis

Diagnostic Techniques Used To Detect: Colorectal Cancer

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Diagnosis of colorectal cancer is a multistep process.

A diagnosis usually starts with a visit to your primary care doctor who is responsible for your overall health care or an internist. Your primary care doctor will:

  • Take a medical history.
  • Perform a physical examination.
  • Make recommendations for procedures including lab tests that may be warranted by your symptoms.

If there is any concern that colorectal cancer could be present or you are 50 years of age or older and have not had a diagnostic procedure known as a colonoscopy, you will generally be referred to a medical specialist known as a gastroenterologist.

A gastroenterologist will generally:

  • Review your medical history.
    • A medical history is a listing of your current and past symptoms, as well as your personal and family medical history.
    • Your family history of colorectal cancer is very important if you are under the age of 50 and having any symptoms. (Survivorship A to Z provides a Symptoms Diary to help you keep track).
  • Give you a physical exam: During a physical exam, your doctor is likely to check for general signs of health. He or she is also likely to give you a digital rectal exam (DRE).

The gastroenterologist may use one or more of the following techniques to determine if you have colorectal cancer. Which test(s) will be used depends on your individual situation. 

  • Colonoscopy (Colonoscopy is considered the "Gold Standard" of colorectal cancer diagnostic tests. A colonoscopy can detect lesions that could become cancer or are cancerous. It can also remove them during the same procedure.)
  • Fecal or stool tests. There are 3 fecal or stool tests in use today:
    • Fecal occult blood test (FOBT)
    • Fecal immunochemical test (FIT)
    • Stool DNA test (sDNA)
  • Sigmoidoscopy

If one of the above tests indicates that cancer is present, one of more of the following tests can show whether the cancer has spread to other parts of the body:

If type II colon cancer is present, an Oncotype DX test may be recommended.

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