Colon cancer is the third most common form of cancer; however, excellent screening tests are available and, if detected early, it is curable in 90% of cases. This is why it is so important to undergo the recommended tests. Go to the family doctor to find out how to do a self-examination at home through the stool test; this is a procedure that should be done every one to two years by people over 50. In Italy, many ASLs provide for a screening program for this cancer to which all people over 50 are automatically inserted at the age of 50. Although the tests performed by qualified doctors are undoubtedly more reliable, even a home test is still better than nothing and could allow you to detect a health problem that must be addressed without delay.
Steps
Method 1 of 2: Perform a Home Stool Test
Step 1. Examine your risk level for colon cancer
Anyone over the age of 50 is a candidate for screening for this disease; however, if you are familiar with this cancer or suffer from inflammatory bowel disease (such as Crohn's disease or ulcerative colitis - both of which increase the risk of this cancer), you may be tested earlier. Don't wait to talk to your doctor about it; even if you are still young, it is important to point out that you are in a risk category.
See your doctor at age 50 to start the self-examination process, but even earlier if you think you have additional risk factors (in which case, the doctor can tell you at what age you can start)
Step 2. Get the screening kit
The first thing to do is to get the necessary material. To obtain it you must go to the family doctor, who will explain the procedure during the visit, as well as undergo a physical examination; in many cases, it is the ASL itself that sends it directly home.
- One of the stool tests is referred to as an "occult blood test" (FOBT); detects blood traces that are not visible to the naked eye and is the most common test used for this purpose.
- An alternative to FOBT is the fecal immunochemical test (FIT); it is very similar to the previous one, but instead of detecting blood thanks to the presence of the heme group, it searches for it through antibodies directed towards human hemoglobin.
- The latest home screening test is called Cologuard®, and is able to detect the presence of blood in the stool, as well as analyze the genetic characteristics associated with a high risk of colon cancer. This is a fairly advanced technology and is not currently recommended as a standard diagnostic method; however, some studies indicate that this new test may potentially be able to detect the presence of cancer cells better than FOBT and FIT are.
Step 3. Collect as many stool samples as required
Once you have received the kit at home, you can start testing the first time you need to defecate. Make a note of the amount of samples you need; for some types of tests, three are required, most often the size of a small stain on toilet paper. In other cases, only one sample is sufficient, but in this case you have to collect and package all the fecal material produced in an evacuation to send it to the laboratory for analysis.
- An easy way to collect the sample is to cover the toilet bowl with plastic wrap letting it dangle just above the water level.
- After you have defecated, you can retrieve the stool sample (in the amount you are asked to) before flushing the toilet and discard the rest as usual.
- Make sure the urine does not contaminate the sample.
Step 4. Store the sample at room temperature (or as directed on the kit package)
This is particularly important until it is delivered to the laboratory, which should receive it no later than 7 days from the time you collected it.
Step 5. Deliver it to the nearest pharmacy or hospital
Once collected and stored in the appropriate way and place, you must have it delivered to the pharmacy (if it is an examination that is part of the regional prevention program), which will promptly send it to the analysis laboratory. If it was a screening exam prescribed by the doctor, who gave you the kit, you must return it to the appropriate hospital.
Step 6. Make a doctor's appointment after receiving the results to interpret them with him
Once you have the test results, you should go back to your doctor to assess what has emerged. Depending on whether the test is positive (suspicion of possible colon cancer) or negative (no cause for concern), your doctor can guide you through the next steps if further tests are needed.
Method 2 of 2: Steps Following the Test Result
Step 1. Relax if you have had a negative outcome
If the stool test result is negative for blood (or DNA), you can feel comfortable knowing that your risk of colon cancer is very low. Of course, no test is perfect, and there can always be a small chance of error, but it is more likely that you are not at risk. Your doctor can then advise you to proceed normally with your daily activities and no further tests are required at this time.
- People over the age of 50 typically repeat stool tests every one to two years to maintain constant monitoring.
- Make a note to remind yourself to go to the family doctor when you need to take the test again.
Step 2. If the result is positive, you need to undergo a colonoscopy
In this case, it is necessary to proceed with further investigations and the next phase consists in the colonoscopy, a diagnostic test that involves the insertion of a tube equipped with a video camera (endoscope) into the anus; this probe runs throughout the intestine and allows the doctor to observe the colon walls to look for any suspicious polyps or lesions. If there are any, a biopsy is usually performed at the same time, taking a sample of tissue that will be analyzed under a microscope to understand if cancer cells are present.
- If the exam does not reveal anything of concern, you should not be afraid and can feel safe continuing your normal life.
- If, on the other hand, a tumor is found, you should go to an oncologist (cancer specialist) to find the best treatment for your situation.
Step 3. Know that a positive stool test result (the screening test you do at home with the kit) does not necessarily indicate the presence of cancer
You don't have to worry too much about this type of exam; the purpose of the test is not in fact to diagnose cancer, but to understand which subjects are at high risk and who must therefore proceed with the colonoscopy to obtain more precise data, since this is the only official examination that allows to obtain a certain diagnosis.
- If the home test reveals blood in the stool, there is a possibility of colon cancer, but this is not a formal diagnosis.
- If possible, you shouldn't be overly concerned as long as you don't proceed with further investigations and undergo a colonoscopy.
- Furthermore, the positive aspect is that if you continue to carry out regular self-exams, any colon cancer can be detected promptly and can therefore be treated and cured (remember that 90% of cases of this tumor form are treatable, if addressed early.).
