It means that further tests and/or investigations are needed to determine the underlying cause of your symptoms.
If you receive a positive faecal immunochemical test result or have higher-risk symptoms such as blood in poo or rectal bleeding, you should receive an urgent referral and have a colonoscopy within 30 days.
Further investigations will usually take place at a clinic in your local hospital.
The specialist will ask you questions about your symptoms (similar to questions asked by your GP), your general health and other medical conditions you might have.
You will sometimes be given the results from investigative tests immediately, or you will be called back to the hospital at a later date to receive the results.
If the further investigations for bowel cancer are negative, you may be diagnosed with another common gastrointestinal condition and given appropriate treatment.
If the further investigations confirm bowel cancer, you will meet with a specialist who will put together your treatment plan.
The following table details considerations when deciding with your GP and/or specialist what test is right for you.
| Benefits and limitations
A computer puts the pictures together to create detailed images that may show polyps and anything else that seems unusual on the inside surface of the bowel.
If the detailed images show polyps and anything else that seems unusual and your specialist wishes to perform a biopsy, you will need to have a colonoscopy.
It has an established place in investigation of symptomatic patients and following incomplete colonoscopy.
The risk for procedure-related complications is low, although CT involves larger radiation doses than the more common, conventional x-ray imaging procedures.
Several studies indicate that magnetic resonance colonography (MRC) could become an alternative to Computerised Tomographic Colonography (CTC) for imaging the large bowel, not having the disadvantage of radiation exposure.
MRI of rectal cancers is currently proposed as a technique for pre-operative staging of rectal cancers and as a technique for re-imaging cancers following pre-operative radiotherapy.
Before the scan, the patient may be given an injection of dye into a vein in the arm, to improve the image.
The scan takes about 30 minutes, during which time the patient will lie inside a chamber which is often long and narrow.
This can feel claustrophobic.
People who have heart monitors, pacemakers or certain types of surgical clips cannot have an MRI because of the magnetic fields.
A sigmoidoscope is inserted through the anus and rectum into the lower part of the colon (sigmoid colon).
A sigmoidoscope is a thin, tube-like instrument with a light and a lens for viewing.
It may also have a tool to remove polyps or tissue samples, which are checked under a microscope for signs of cancer
The patient lies on an x-ray table and a liquid that contains barium (a silver-white metallic compound) is put into the rectum.
The barium flows through the colon and coats the lower gastrointestinal tract.
X-rays are taken to look for abnormal areas.
Any abnormal areas show up as black against the white liquid.
This procedure is also known as a lower gastrointestinal (GI) series.
Screening test results may appear to be normal even though bowel cancer is present. A person who receives a false-negative test result (one that shows there is no blood in poo when there really is) may delay seeking medical care.
Screening test results may appear to be abnormal even though no blood in poo is present. A false-positive test result (one that shows there is blood in poo when there really isn't) can cause anxiety and is usually followed by more tests (such as colonoscopy), which also have risks.
Using a poo sample, Cologuard detects hemoglobin, a protein molecule that is a component of blood. Cologuard also detects certain mutations associated with bowel cancer in the DNA of cells shed by advanced adenomas as poo moves through the large intestine and rectum. Patients with positive test results are advised to undergo a diagnostic colonoscopy.
The blood test is the result of a collaboration between CSIRO, Flinders University and Clinical Genomics.
According to CSIRO, bowel cancer usually recurs in the first two to three years following initial diagnosis and treatment, in 30-50 percent of cases.
The current method of monitoring for recurrence is through a blood test for CEA (carcinoembryonic antigen), together with CT scans and other clinical assessments.
“By providing clinicians with a new blood test that is more sensitive for recurrence than CEA, Colvera increases the likelihood of detecting curable recurrences of bowel cancer, with the ultimate aim of saving lives,” CSIRO Scientist Dr Trevor Lockett said.
According to Professor Graeme Young of Flinders Centre for Innovation in Cancer said, “Our study has shown that Colvera is significantly more sensitive for bowel cancer than CEA and as such provides us with an improved, simple test that increases the likelihood of detecting curable recurrence.”
The blood test is not currently available in Australia.