Concerns about colorectal cancer?
Hello Dr.
Tsai, I am 46 years old and had a colonoscopy three years ago, during which several small polyps were found and removed.
The pathology report indicated that they were benign polyps.
The doctor advised me to have another colonoscopy in 3 to 5 years.
In February of this year, I had a CT scan due to a ureteral stone, and the results were normal with no abnormalities.
However, in the past 2 to 3 months, I have been experiencing intermittent mild cramping pain in the lower left abdomen near the navel, which comes and goes.
Recently, after using the restroom, I noticed fresh blood on the toilet paper, about the size of a ten-dollar coin.
I would like to ask Dr.
Tsai if, given that I had a colonoscopy only three years ago and a CT scan of the abdomen and pelvis in February, there is a possibility that this could develop into colorectal cancer? Thank you for your guidance!
JACKY, 40~49 year old female. Ask Date: 2017/05/15
Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: Noticing fresh blood when wiping the anus is most commonly associated with hemorrhoids or anal fissures.
However, if there is unusual and persistent bleeding, it is still recommended to consult a gastroenterologist or a colorectal specialist.
A colonoscopy performed three years ago does not guarantee that colorectal cancer has not developed since then.
If the tumor is not large enough, it may not be detectable by a CT scan alone; typically, a colonoscopy is required to increase the diagnostic rate.
Changhua Hospital cares about your health.
Dr.
Tsai An-Shun.
Reply Date: 2017/05/15
More Info
Concerns about colorectal cancer are valid, especially given your recent symptoms and medical history. At 46 years old, you are within the age range where screening for colorectal cancer becomes increasingly important. The fact that you had polyps removed during your last colonoscopy three years ago indicates that you are at a higher risk for developing colorectal cancer, as certain types of polyps can progress to cancer over time.
Your recent symptoms, particularly the intermittent left lower abdominal pain and the presence of bright red blood on toilet paper, warrant further investigation. Bright red blood typically suggests that the bleeding is coming from the lower gastrointestinal tract, which could be due to a variety of causes, including hemorrhoids, anal fissures, diverticular disease, or potentially more serious conditions like colorectal cancer.
Given that you had a normal CT scan of the abdomen and pelvis in February, it is reassuring that there were no significant findings at that time. However, the development of new symptoms, especially the presence of blood, should not be ignored. The timeline of your symptoms is also important; the fact that you are experiencing these symptoms now, a few months after your last imaging, suggests that a follow-up is necessary.
It is recommended that you consult with your healthcare provider as soon as possible. They may suggest a repeat colonoscopy, especially since it has been three years since your last one. This will allow for a direct visual examination of the colon and rectum, and any new polyps or lesions can be biopsied if necessary. Additionally, your doctor may consider other diagnostic tests, such as blood tests to check for anemia or inflammatory markers, which can provide further insight into your condition.
In terms of screening guidelines, the American Cancer Society recommends that individuals at average risk begin screening for colorectal cancer at age 45. However, those with a history of polyps or other risk factors may need to start screening earlier or have more frequent screenings. Since you had polyps removed, your doctor may recommend a follow-up colonoscopy sooner than the typical 10-year interval for average-risk individuals.
In summary, while your previous screenings and imaging results are reassuring, the new symptoms you are experiencing are concerning and should be evaluated promptly. Early detection is key in managing colorectal cancer effectively, and addressing any potential issues as soon as they arise can significantly improve outcomes. Please make an appointment with your healthcare provider to discuss your symptoms and the next steps in your care.
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Related FAQ
Colorectal Cancer
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Colonoscopy(Gastroenterology and Hepatology)
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Rectum(Gastroenterology and Hepatology)
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