Michelle Greiver, M.D., C.C.F.P.
Family Physician
240 Duncan Mill road, suite 705
Toronto, Ontario M3B 3S6
Phone (416) 222-3011
Fax (416) 221-3097
Email  mgreiver@rogers.com


                                      Colorectal Cancer Screening

What is Colorectal Cancer?
Colorectal cancer is cancer of the lower bowel; about 1 in 20 people will get this cancer sometimes during their life. Colorectal cancer becomes more common with age, and is rare before the age of 50.  About 40% of patients who get colorectal cancer will die from it.

Can we detect early Colorectal Cancer?
This cancer starts as a polyp (a small abnormal growth).  If detected early, the polyp can be removed, which prevents cancer from developing.
There are several ways of detecting polyps.  In Canada, the recommended method is the Fecal Occult Blood test.  This is a kit that checks for small quantities of blood leaking into the stool from a polyp.  The amount of blood is usually so small that it can’t be seen.
You have been given a kit for this, to do at home and bring back to my office.  Please follow the instructions as written on the kit.  If you are on coumadin or one Aspirin daily for your heart, you can continue to take those; do not take anti-inflammatory medications, because they make your bowels bleed.

How good is the Fecal Occult Blood test at finding cancer?
No test is perfect.  Sometimes, a negative test misses a cancer; however, doing this test on a yearly basis improves the odds of detecting the cancer.
If you have a positive test, then I send you for a colonoscopy.  This is a test where a long flexible tube connected to a camera is put in the lower bowel through the rectum; the specialist can have a look at the entire colon and rectum, and remove polyps if they are found.  Most patients with a positive stool test will have a normal colonoscopy; between one out of ten and one out of twenty will have a polyp or cancer.
Colonoscopies are reasonably safe, but you do have to take strong laxatives beforehand to clean the lower bowel, and there is a one in a thousand chance of causing a perforation (making a hole in the bowel) during the procedure.
Because the Fecal Occult Blood test has been proven to decrease the risk of dying of Colorectal cancer, I recommend it for patients over the age of 50.  Doing the test is your choice; if you are not sure, or have any questions, please ask me.