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Brattleboro Memorial Hospital

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One of the many unfortunate consequences of COVID-19 was the nearly universal pause in colonoscopies and other life-saving cancer screening procedures. Fortunately, as the pandemic fades, people are getting back to their normal schedule of healthcare appointments. As they do so, they’re also learning about the various options they have when it comes to colorectal cancer screening.

As a general surgeon, I’ve seen my share of patients with colorectal cancer. That’s why I’m a huge champion of regular colonoscopy (at least once every 10 years) starting at age 45 for most adults. The colonoscopy remains the “gold standard” for accuracy in detecting precancerous polyps and colorectal cancer at its earliest and most treatable stage.

In many cases, precancerous polyps can be removed during a colonoscopy. And if cancer is discovered, it’s encouraging to know that early treatment really can make a world of difference.

For people who may be unsure of or put off by the prospect of a colonoscopy, other less time-consuming screening methods are available. I’d like to discuss them briefly in this short piece and encourage you to have a more in-depth talk about them with your healthcare provider.

A test you can do at home is available under the brand name Cologuard. It detects changes in DNA at the cellular level along with hidden blood that can indicate colon cancer or precancerous conditions. All you need is a stool sample. Otherwise, it won’t disrupt your daily activities, and you can eat and drink normally. This test is usually repeated every three years. It is not as sensitive as a colonoscopy.

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THE FIT Card is another fairly easy home-based test that’s designed to check stool samples for hidden blood. FIT stands for fecal immunochemical test, and it’s the kind of test that’s usually repeated annually. You may need to avoid certain foods and medications several days before the test.

You can also talk to your healthcare provider about the pros and cons of screening tests such as flexible sigmoidoscopy (similar to a colonoscopy, but only checks the lower third of the colon) and CT colonography (virtual colonoscopy), which produces computerized images of the colon that can be analyzed by a trained physician.

Several factors should be considered when deciding which test is right for you. These include the amount of preparation involved, the convenience of the test, cost and insurance issues, and your healthcare provider’s recommended approach to colorectal cancer screening.

Your risk level for colorectal cancer should also be a key factor in your decision-making process. Does the disease run in your family, or do you happen to carry a gene that’s associated with colon cancer? Do you have Crohn’s disease or ulcerative colitis? Answers to these questions might influence your healthcare provider’s screening recommendations and your ultimate choice for testing.

I raise these issues not only because March is Colorectal Cancer Awareness Month but because I am convinced that colorectal cancer screening saves lives. I strongly encourage you to weigh the various screening options and then schedule the test that’s right for you.

John Cope, MD, is a board-certified surgeon practicing at Brattleboro General Surgery, a department of Brattleboro Memorial Hospital. For more information or to make an appointment at Brattleboro General Surgery, call 802-251-8650 or visit