Colorectal cancer screening
The prevention of colorectal cancer in the Czech Republic currently consists in two types of physical examination: faecal occult blood test (abbreviated as FOBT) and screening colonoscopy. However, there are significant differences between these two procedures (compare faecal occult blood test and screening colonoscopy). From the age of 50 onwards, you can choose between screening colonoscopy, which should be performed every 10 years, or FOBT, which is recommended at the following intervals: once a year for those aged 50–54 years, and once every two years for those aged 55 and over. Unfortunately, FOBT alone is not sufficient to make a definitive diagnosis. If the test is positive (i.e. if traces of blood are found in the stool sample), a colonoscopy will then be recommended. This is the only way to find out the exact cause of bleeding.
We talk about screening colonoscopy if you decide to skip the FOBT altogether. The recommended interval between two screening colonoscopies is up to 10 years, as colonoscopy provides much more reliable test results. If this examination does not even detect a polyp (a growth that could develop into a malignant tumour), then you can be almost 100% sure that you will not develop colorectal cancer within the next ten years.
Faecal occult blood test (FOBT)
The fecal occult blood test (FOBT) is simple and completely painless. In practice, it only involves the collection of a stool sample, in which traces of blood, invisible to the naked eye, can be chemically detected (traces of blood may indicate a malignant tumour of the bowel). The test is carried out in the comfort of your own home. With modern types of FOBT, there is also no need to follow a diet, as the results of these latest tests are no longer influenced by eating certain types of food.
A significant disadvantage of FOBT is that the presence of blood in the stool may not yet be related to colorectal cancer. FOBT is definitely not a “cancer test”! A positive test result may indicate “only” the presence of polyps, Crohn’s disease or diverticulitis. If the FOBT result is positive and you want to be sure that you are not at risk of colorectal cancer, then you have no choice but to make an appointment for a colonoscopy. However, it is clearly true that any prevention is always much better than no prevention at all. A stool occult bleeding test is the minimum you can do for yourself in this respect.
Screening colonoscopy is clearly a more reliable test than the faecal occult blood test (FOBT) in all aspects. Even suspicious growths (polyps) in the intestine can be removed during the colonoscopy examination, thus avoiding conventional surgery, which often entails a lot of trouble. For some people, colonoscopy is not a major problem, while others find it a very unpleasant experience. However, thanks to so-called analgosedation (a combination of an analgesic and a sedative), it is now possible to alleviate the painful sensations in more sensitive individuals, who can then manage this formerly dreaded procedure without any distress. General anaesthesia is then the last resort.
A colonoscope is a special type of endoscope (a medical device that consists of an optical apparatus attached to the end of a “tube” and a monitor). The colonoscope “tube” is about the diameter of a child’s little finger and measures about one metre in length. During the actual colonoscopic examination, this “tube” is very carefully inserted into the rectum and then into the colon. Thanks to the sensitive optical system, the doctor observes a realistic picture of the colon on the monitor, and can safely detect diseases that even an X-ray would not reveal. In addition, the colonoscope also allows tissue samples to be taken for further assessment, and it can also remove (cut out) unwanted polyps straight away: a colonoscopy can therefore save your life without having to undergo much more extensive surgery in the future.
During the procedure itself, you usually lie comfortably on your left side and are informed in detail by the staff about all the following steps. Administration of an intravenous injection containing painkillers is commonplace. Before the examination itself, however, it is very important to follow all the instructions you are given in preparation for the examination (as regards drinking, emptying your colon using laxatives etc.). It would certainly be pointless to undergo a colonoscopy repeatedly just because you did not prepare sufficiently for the examination.
Screening colonoscopy is performed by a qualified gastroenterologist. The whole procedure usually takes around twenty minutes. The next thirty minutes or more are reserved for rest, which you should generally have for the rest of the day. You should find out the result immediately or within a few days (if samples had to be taken). You can eat and drink immediately, but it is still advisable to choose more easily digestible foods at least until the evening.
The choice of a particular screening centre – and making an appointment – is up to you. You can use our list of accredited centres.