Colorectal Cancer Screening & Treatment

Colon cancer screening is one of the most important things you can do to protect your life and the lives of those you love. It has been stated that ninety-five percent of colon cancer cases are curable if detected and treated early. If you are interested in being screened for colon cancer, but have concerns about paying for the screening, you are not alone. There is hope! Some doctors, clinics, and hospitals, as well as healthcare providers will provide colon cancer screening to those in need at no cost or at reduced prices. See the list below for some of these complimentary and discounted screening offerings. Please help others in need and contact us if you know of additional resources.

We urge you to research the various screening techniques and payment options for low-income individuals. However, you must exercise due diligence and caution in your research and decision making. There are many scams out there and not everything claiming to be a good cause really is. Be wise and research all options fully.

Cannot Afford Treatment?

Contact the Samaritan House of San Mateo
4031 Pacific Boulevard
San Mateo, CA 94403
View Map  |  Phone: (650) 341-4081

http://samaritanhouse.com/new/home/index.shtml

Samaritan House of Redwood City
114 Fifth Ave
Redwood City, CA 94063
View Map  | Phone: (650) 839-1447

Insurance Coverage for Colorectal Screening 

Invasive Tests

Colonoscopy:

In today’s medicine, this procedure is considered the “gold” standard in diagnosing colorectal cancer. After the patient cleans out his or her bowel, a doctor passes a tube (with camera attached) into the large intestine to look for polyps. During the test, the doctor can pass surgical tools into the tube to take tissue samples out for biopsies.

Currently the most accurate diagnostic test. Looks at entire colon. Polyps can be directly removed.

Expensive, requires dietary preparation to clean out bowel, and is often uncomfortable. About 3 to 5 in 1000 patients will experience bleeding, ulcers, or a perforated colon.

 

Flexible Sigmoidoscopy:

Similar to a colonoscopy, a sigmoidoscopy uses a very narrow tube attached with a camera at the end to look for polyps.

Preparation is less complicated compared to colonoscopy, and sedation is usually not needed. Polyps can be removed during surgery.

Unlike a colonoscopy, this procedure only examines the left side of the colon (rectum and sigmoid colon). Although the preparation is less tedious and the test is more comfortable, a sigmoidoscopy is only a partial exam. Therefore, cancer in the unexamined regions may not be detected. If a flexible sigmoidoscopy is chosen over a colonoscopy, patients are recommended to use a FIT test too.

 

Alternate Methods (Less Invasive)

Double Contrast Barium Enema (DCBE)

This is an X-ray test that creates an outline of the intestinal lining. During the test, a thin tube is put into the patient’s rectum and both barium sulfate (a chalky liquid used as the contrast) and air is pumped to expand the colon and rectum. 

Less expensive than a colonoscopy. Sedation is not needed.

A DCBE usually requires cleansing of the bowel beforehand. Undergoing this procedure includes a very small risk of air puncturing the colon. If polyps are found or the doctor administering the test is suspicious of cancer, a colonoscopy will be needed. Patient exposed to a very small amount of radiation.

 

CT/Virtual Colonoscopy

Again, a small tube is put into the rectum to fill it with air and the bowel needs to be cleaned. The patient will sit on a table that slides into a CT scanner. It is virtual colonoscopy that uses X-rays to take many pictures at a time, which makes 2D or 3D pictures of the colon and rectum. 

The test takes only about 10 minutes. Unlike a colonoscopy, this test in noninvasive. Sedation is not needed.

Expensive and requires bowel preparation. If polyps are found, a colonoscopy is usually required for further investigation. Patients exposured to a very small amount of radiation.

 

Stool Blood Tests

Guaiac-based fecal occult blood test (gFOBT)

This test looks for blood from hemoglobin based on a nonspecific peroxidase reaction. You take a swab of your stool and send back to the clinic for lab results.

Inexpensive and convenient. Done at home.

Because guaiac-based FOBT does not find most polyps and cancers, and has a high false-positive rate if dietary preparation is not thorough enough, gFOBTs are no longer recommended. Another flaw to this test is that if there is blood detected, doctors do not know whether the blood came from the colon or another part of the digestive tract. A colonoscopy is required for further investigation if test is positive. Inflammation, ulcers, hemorrhoids, and medical conditions can cause blood to be present in stool, which sometimes lead to false positives.

 

Fecal Immunochemical Test or FIT

FIT (also called iFOBR) is currently the most popular blood test and is commonly used as the “first-line of defense” screening method. It tests for hidden blood in the stool, which is one of the earliest (if not the earliest) sign of colon cancer. When food waste brushes against the polyps, the polyps may bleed and the blood may become mixed with the stool. Take a swab of your stool and send back to clinic for lab results.

Unlike a colonoscopy, FIT is noninvasive, inexpensive, and has no risks. There are few if any dietary, drug, or dental procedure restrictions involved. It is conveniently done at home. Successive use of FIT has been shown to be just as effective and accurate as a one-time colonoscopy. When coupled with colonoscopy – FIT has been shown to find colorectal cancer up to two years earlier than colonoscopy alone.

A colonoscopy is required for further investigation if test is positive. Inflammation, ulcers, hemorrhoids, and medical conditions can cause blood to be present in stool, which sometimes lead to false positives.

Second Generation FIT

Second Generation FIT specifically looks at very small traces of gloubin levels in the stool sample. Elevated globulin, which is a component of hemoglobin, is one of the main biomarkers for colorectal cancer.

Inexpensive test that takes 5 minutes or less. You will know your results immediately after collection of sample without having to send to a lab.

A colonoscopy is required for further investigation if test is positive. Other than those from Pinnacle Lab (the manufactures of FIT), there are not many studies on the accuracy of Second Generation FIT.

 

Stool DNA Tests

Cologuard

Cologuard is a new combined DNA and blood stool test that was approved by the FDA in 2014. It tests for eleven distinct biomarkers and the presence of occult hemoglobin in human stool. Sample of stool is sent to clinic for lab results.

Cologuard is the only screening test that looks at multiple biomarkers and stool DNA simultaneously that may signfiy colorectal cancer or precancer. No dietary prep is needed and it can be performed conveniently at home. Less expensive than an invasive test.

More expensive than a regular blood stool test. A colonoscopy is needed if test result is positive. Laboratory must receive sample within 72 hours of collection for maximum accuracy. Studies have not yet been done to show the benefits and risks of long-term use of Cologuard. Some studies show promising results, while other studies show more false positives and negatives than FIT. Cologuard acknowledged that their test has 87% specificity (ability of the test to correctly identify those without the disease) compared to 95% for a leading fecal immunochemical test.  Inflammation, ulcers, hemorrhoids, and medical conditions can cause blood to be present in stool, which sometimes lead to false positives.