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Tests and diagnosis
By Mayo Clinic staff
Diagnosing colon cancer
If your signs and symptoms indicate that you could have colon cancer, your doctor may recommend one of more tests and procedures, including:
- Blood tests. Your doctor may order blood tests to better understand what may be causing your signs and symptoms, but there are no blood tests that can detect colon cancer. Blood tests may include a complete blood count and organ-function tests.
- Using a scope to examine the inside of your colon. Colonoscopy uses a long, flexible and slender tube attached to a video camera and monitor to view your entire colon and rectum. If any suspicious areas are found, your doctor can pass surgical tools through the tube to take tissue samples (biopsies) for analysis.
- Using dye and X-rays to make a picture of your colon. A barium enema allows your doctor to evaluate your entire colon with an X-ray. Barium, a contrast dye, is placed into your bowel in an enema form. During a double-contrast barium enema, air also is added. The barium fills and coats the lining of the bowel, creating a clear silhouette of your rectum, colon and sometimes a small portion of your small intestine.
- Using multiple CT images to create a picture of your colon. Virtual colonoscopy combines multiple computerized tomography (CT) images to create a detailed picture of the inside of your colon. If you're unable to undergo colonoscopy, your doctor may recommend virtual colonoscopy.
Staging colon cancer
Once you've been diagnosed with colon cancer, your doctor will then order tests to determine the extent, or stage, of your cancer. Staging helps determine what treatments are most appropriate for you. Staging tests may include imaging procedures such as abdominal and chest CT scans. In many cases, the stage of your cancer may not be determined until after colon cancer surgery.
The stages of colon cancer are:
- Stage 0. Your cancer is in the earliest stage. It hasn't grown beyond the inner layer (mucosa) of your colon or rectum. This stage of cancer may also be called carcinoma in situ.
- Stage I. Your cancer has grown through the mucosa but hasn't spread beyond the colon wall or rectum.
- Stage II. Your cancer has grown into or through the wall of the colon or rectum but hasn't spread to nearby lymph nodes.
- Stage III. Your cancer has invaded nearby lymph nodes but isn't affecting other parts of your body yet.
- Stage IV. Your cancer has spread to distant sites, such as other organs — for instance to your liver or lung.
- Recurrent. This means your cancer has come back after treatment. It may recur in your colon, rectum or other part of your body.
- Compton C, et al. Colon cancer. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008:1477.
- What you need to know about cancer of the colon and rectum. National Cancer Institute. http://www.cancer.gov/cancertopics/wyntk/colon-and-rectal/allpages/print. Accessed July 2, 2009.
- Colon cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/colon.pdf. Accessed July 2, 2009.
- Cappell MS. Pathophysiology, clinical presentation and management of colon cancer. Gastroenterology Clinics of North America. 2008;37:1.
- Wilkes G, et al. Colon, rectal and anal cancers. Seminars in Oncology Nursing. 2009:25:32.
- Distress management. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/PDF/distress.pdf. Accessed July 7, 2009.
- Levin B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: A joint guideline from the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA: A Cancer Journal for Clinicians. 2008;58:1.
- Colon cancer screening (Colorectal). Medicare.gov. http://www.medicare.gov/health/coloncancer.asp. Accessed July 7, 2009.
- Young MC. Colon cancer. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/147305686-4/0/1494/0.html. Accessed July 2, 2009.
- Elwood PC, et al. Aspirin, salicylates and cancer. The Lancet. 2009;373:1301.
- Rex DK, et al. American College of Gastroenterology guidelines for colorectal cancer screening 2008. American Journal of Gastroenterology. 2009;104:739.
