Colorectal Cancer Screening and Early Detection

Schedule Your Screening

Talk to your primary care provider about colorectal cancer screening. You may be referred for a colonoscopy or an alternative screening test. If you need a colonoscopy, call 206.606.5342 to schedule your procedure at Fred Hutch Cancer Center - South Lake Union. 

Up to 90% of colorectal cancers can be cured if they are found early. But once cancer spreads outside the colon, it is much harder to treat. That’s why regular colorectal cancer screenings, beginning at age 45, are recommended and so important. At Fred Hutch Cancer Center, we offer a full range of screening options to reduce the risk of developing colorectal cancer or to detect it at its earliest stage.

We are also making colorectal screening easier to access and complete through our Population Health Colorectal Cancer Screening Program. This program helps people in our region who have historically been disadvantaged due to factors related to race, ethnicity or socioeconomic status. Another goal is to share the program's blueprint locally and nationally as a resource for other institutions to follow.
 

Are You at Higher Risk?

Several factors can increase someone’s risk of developing colorectal cancer, like being over the age of 45, smoking, drinking high amounts of alcohol and eating a lot of processed foods or red meats. Also, if a person has a family history of colorectal cancer, certain genetic mutations or an inflammatory bowel disease (IBD) such as Crohn’s disease or ulcerative colitis, they are considered at high risk for developing colorectal cancer compared to people who do not have this medical history.

If you fit into one of these high-risk categories, you should talk to your physician about screening options, as you may need to be screened earlier than age 45 or more often.
 

Population Health Colorectal Cancer Screening Program

According to the American Cancer Society, about 1 in 3 people in the U.S. who should be tested for colorectal cancer have never been screened. There can be many reasons: not knowing they should be screened, high out-of-pocket costs, fear of screening or logistical issues like lack of transportation.

The Fred Hutch-UW Medicine Population Health Colorectal Cancer Screening Program was designed to lower the burden of colorectal cancer, especially among racial, ethnic and low-income populations, by reducing the barriers that stop people from getting screenings or follow-up of abnormal noninvasive screening tests.
 

Rachel Issaka

“Our program is designed to reach populations who infrequently come to clinic but are at risk of developing colorectal cancer. We aim to help as many people as possible complete screening, to navigate them to treatment if they are diagnosed with colorectal cancer, and to do so guided by a focus on achieving health equity.”

– Rachel Issaka, MD, MAS, Program Director, Population Health Colorectal Cancer Screening Program

Types of Screening Options

Your physician will decide which test is best for you and will explain what you need to do.

Visual Tests

  • Colonoscopy: Looks at your entire colon and rectum using a flexible, lighted tube with a video camera on the end. This tube goes into your colon, and your physician can also remove polyps (growths) during this test.
  • Flexible sigmoidoscopy: Looks at your rectum and the lower part of your colon for polyps (growths) or tumors using a tiny, flexible, lighted tube.

Stool-Based Tests

  • Fecal immunochemical test (FIT): Checks for blood in your stool that could be caused by colon polyps (growths) or colorectal cancer.
  • Stool DNA test (Cologuard): A combination of a FIT plus a test that checks cells in your stool for abnormal DNA. Together, these tests may show that you have polyps or cancer.

Imaging Test

  • Computed tomographic (CT) colonography: Creates detailed pictures of your colon and rectum using X-rays; also called virtual colonoscopy. This test is done at the University of Washington Medical Center.


If you have an abnormal FIT, Cologuard or CT colonography, you will need to also get a colonoscopy to understand why the test is abnormal.

Learn More About Colonoscopy

All colorectal screening tests give us valuable information, but colonoscopy is the test that is used most often in the U.S. During a colonoscopy, a physician can look at your colon, and if a polyp (growth) is found, they can usually remove it at the same time and send it to a lab for testing. The lab will then send back the results, and you will be able to go over them with your physician.

How to Prepare for a Colonoscopy

When you make your appointment, your care team will give you detailed instructions on how to get ready for a colonoscopy.

In the day or two before your colonoscopy, you will need to follow a special diet. This usually means drinking clear liquids like water, broth or clear juices and avoiding solid foods. You will also need to take a bowel prep solution to empty your colon, so it's important to stay near a bathroom. Because you will need to be sedated (with a drug that will help you relax and be comfortable during the procedure), you won’t be allowed to drive afterwards, so make arrangements ahead of time for a friend or family member to drive you home.

What Happens During a Colonoscopy

During a colonoscopy, you'll be given a sedative (a drug that will help you relax and be comfortable during the procedure). Once you're sedated, the physician will put a thin, flexible tube called a colonoscope into your rectum to look at the inside of your colon. The colonoscope has a tiny camera on the end that allows your physician to view your colon on a screen and check for any abnormalities, such as polyps (growths) or inflammation. If anything is found, your physician can remove it and send it to a lab for testing. The procedure usually takes 30–60 minutes.


After a Colonoscopy

Afterward, you will rest for about one hour until the sedative wears off. You might feel weak or groggy, so ask the person driving you home to help you get into and out of your vehicle. Most people can return to normal activities or work the next day.

If Your Colonoscopy Does Not Reveal Any Polyps

If your colonoscopy does not find any polyps, this means there are no signs of abnormal growths in your colon. In this case, your physician will likely recommend a routine follow-up colonoscopy based on your age and medical history, usually every 10 years for most people. However, if you have a family history of colorectal cancer or other factors that put you at higher risk, your physician may recommend screenings more often to help make sure your colon stays healthy.

If Your Colonoscopy Does Reveal Polyps

If your colonoscopy reveals polyps, your physician will remove them and send them to a lab for analysis. Most polyps are non-cancerous (benign), but some of them could become cancerous.

After the results come back, your physician will get in touch to discuss them with you. If you have polyps that are non-cancerous, you may need to return for colonoscopies sooner, often within three to five years, to monitor for any new growths and ensure early detection and prevention of colorectal cancer.

Frequently Asked Questions (FAQs)

Yes. Even if you don’t have symptoms, screening is important. Colon cancer can develop without noticeable symptoms, especially in the early stages, so regular screening helps catch issues before they become serious.

For People at Higher Risk of Gastrintestinal Cancers

For people with higher risk of gastrointestinal cancers due to genetic mutations or a family history of cancers, the Gastrointestinal Cancer Prevention Program at Fred Hutch offers a personalized approach to risk assessment, screening and prevention.

Learn more about the Gastrointestinal Cancer Prevention Program.

Your Care Team

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