Colonoscopy. Routine covered one (1) every five (5) years starting at age fifty (50). Subject to deductible and co-insurance.
Colonoscopy. Colonoscopy is a longer tube that reaches the cecum, and if polyps are found they are removed. Compared to sigmoidoscopy, bowel preparation for colonoscopy is more extensive and requires patients to eliminate solid foods and darker liquids from their diet 1 to 2 prior to the test, as well as drink a laxative the evening before the test. Abstaining from drinking liquids 6-8 hours before the test is also recommended. Patients may also choose to be sedated, requiring a chaperone following the procedure. Colonoscopies are typically performed by gastroenterologist or physicians with surgical training. Complications of colonoscopy include cardiopulmonary events associated with sedation, discomfort, perforation, bleeding. 54 gFOBT gFBOT contains guaiac, which turns blue with peroxidase activity of heme, thereby detecting blood in the stool. gFOBT does not specifically detect blood from colorectal polyps and may react to peroxidase from other sources (e.g., red meat, certain fruits and vegetables, blood from hemorrhoids or upper gastrointestinal conditions).55 High doses of vitamin C, aspirin, and other medications, interfere with the peroxidase reaction, increasing the probability of a false negative result, so people are instructed to avoid these products prior to the test.56 To improve the sensitivity of gFOBT, 2 samples from 3 stools are typically collected. If a gFOBT is positive, follow-up with colonoscopy is required to complete the screening process. FIT FIT is a newer stool based test that uses an antibody to detect human globin, which is part of the hemoglobin molecule. Because FIT detects globlin, which degrades throughout the gastrointestinal tract, it is a more reliable source of lower gastrointestinal bleeding and requires only one sample. Additionally, FIT does not rely on peroxidase activity, so there are fewer dietary restrictions associated with FIT. 56 Similar to gFBOT, there are few complications associated with the test and follow-up with colonoscopy is required if the test is positive. sDNA sDNA is the most recent stool-based screening test, approved by the FDA in late 2014.57 sDNA tests examine the stool for genetic mutations associated with CRC and microsatellite instability. Unlike FOBT and FIT, a full stool sample is required for the sDNA tests. sDNA test does not require dietary restrictions and similar to other stool- based tests, require follow-up colonoscopy if the test is positive. CT colonography CT colonography is a newer CRC scree...
