Table of ContentsView AllTable of ContentsHistory and Physical ExamLabs and TestsImagingStagingSurvival RateDifferential DiagnosesFrequently Asked QuestionsNext in Colon Cancer GuideColon Cancer: What Determines Success of Treatment?
Table of ContentsView All
View All
Table of Contents
History and Physical Exam
Labs and Tests
Imaging
Staging
Survival Rate
Differential Diagnoses
Frequently Asked Questions
Next in Colon Cancer Guide
Getting an early diagnosis ofcolon canceris of paramount importance to help improve outcomes - and getting that early diagnosis starts with following routine screening recommendations and knowing your family history.
Clinical guidelines recommendcolon cancerscreening begin atage45 for people at average risk. Screening should begin sooner for anyone who has a family history or other risk factors. One method of screening, colonoscopy, can also serve as a diagnostic test if cancer is present.
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Speaking with your healthcare provider about your medical history is the first step in ensuring your risk for colon cancer is properly evaluated. Your practitioner will talk through the risk factors that might be applicable to you, such as family history. The practitioner will also talk to you about any symptoms you might be experiencing.
Your healthcare provider will examine your abdominal area to check for masses or enlarged organs. You might have a digital rectal exam, during which your healthcare provider inserts a lubricated, gloved finger into the rectum to check for abnormalities.
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After a medical history and physical examination, your healthcare provider may order diagnostic tests, especially if your symptoms and/or exam results indicate that you could have a medical problem.
While labs cannot determine whether or not you have colon cancer, they can provide valuable information in your diagnosis.
Some blood tests your healthcare provider may order include:
Symptoms That May Signal Early Colon Cancer
Diagnostic Colonoscopy
If your physical exam and/or blood tests indicate signs of possible colon cancer, your healthcare provider will recommend more tests. A diagnostic colonoscopy is the most accurate test for diagnosing colon cancer.
If you had a stool-based test or CT scan that came back abnormal, your healthcare provider would order a colonoscopy to confirm a diagnosis.
During a colonoscopy, a gastroenterologist—a practitioner who specializes in treating diseases of the digestive tract—inserts a colonoscope (flexible tube) into youranus. You can watch on a video monitor as the camera is threaded through your rectum andcolon. If you’re thinking about how unpleasant that must be, take heart—you’re sedated during the procedure.
Biopsy
In addition, if a suspicious mass is seen in the colon, the healthcare provider can take a biopsy (tissue sample). A pathologist can look at the sample with a microscope to see if cancer cells are present.
If cancer is found, more lab tests may be performed on the biopsied sample, like tests that look for gene changes in the cancer cells. Results of these tests can help oncologists (cancer doctors) determine what treatments may work best.
How a Colon Biopsy Is Performed
Once the diagnosis of colon cancer is determined, the cancer stage, which is the extent of the disease spread, is determined with imaging tests. After the cancer has been staged, a treatment plan can then be devised.
Imaging tests that are often used include:
There are five stages ofcolon cancer(0–4) and, in general, the earlier the stage, the easier the cancer is to treat.
To understand thebasics of the stages, think of the colon as a hollow tube with five layers: the innermost layer (called the mucosa), the second layer (called the submucosa), a third muscular layer (called the muscularis propia), and the outermost layers (called the subserosa and serosa).
Stage 0
Stage 0 colon cancer is the earliest stage possible and is also called carcinoma in situ (“carcinoma” refers to cancer and “in situ” means original position or place). Stage 0 cancer has not grown beyond the mucosa.
Stage 1
Stage 1 colon cancer means that the tumor has grown through the mucosa into the submucosa or the muscularis propia.
Stage 2
Stage 2 colon cancer means one of the following scenarios:
Stage 3
Stage 3 colon cancer means one of several things:
Stage 4
Like stage 2 and 3 colon cancer, there are a number of different scenarios that describe stage 4 cancer. Stage 4 colon cancer is synonymous with metastatic colon cancer, in which the tumor has spread to one or more distant organs (for example, the liver or lungs), to a distant set of lymph nodes, or to distant parts of the lining of the abdominal cavity (called the peritoneum).
Dealing with a diagnosis of stage 4 cancer can be a quite challenging process, both physically and mentally. For most people, stage 4 colon cancer is not curable, but there are usually treatment options available.
Colorectal cancer
Five-Year Survival Rate
For early-stage cancers that are treated with the expectation of a complete cure, the five-year survival rate is sometimes considered the point at which a person is “out of the woods.” After the five-year mark, it may become less likely for cancer to return.
Some research suggests that people need to be followed closely for up to 10 years after diagnosis. This longer follow-up is to ensure that anycancer recurrencesare caught early.
What Does “Five-Year Survival” Mean?The five-year survival rate is the percentage of people diagnosed with cancer who are still alive at least five years after their initial diagnosis.
What Does “Five-Year Survival” Mean?
The five-year survival rate is the percentage of people diagnosed with cancer who are still alive at least five years after their initial diagnosis.
According to theNational Cancer InstituteandAmerican Cancer Society, the five-year survival rates for people living with colon cancer (based on stage) are as follows:
Keep in MindIt is important to remember that survival rates are estimates. A five-year survival rate can never predict what will happen in any individual case. Other things, such as how cancer responds to treatment and the genetics of the cancer cells, will affect the chances of survival.
Keep in Mind
It is important to remember that survival rates are estimates. A five-year survival rate can never predict what will happen in any individual case. Other things, such as how cancer responds to treatment and the genetics of the cancer cells, will affect the chances of survival.
In addition, to come up with five-year survival rates, health experts collect data about people who were treated for their cancer at least five years ago. Colon cancer treatments have changed and continue to change very quickly, which can improve outcomes.
Some treatments that are used now, such astargeted therapies, weren’t available five years ago. Also remember that survival rates can include people who were diagnosed with colon cancer, but who later died of non-cancer-related causes.
This means that the five-year survival rates will likely look worse than what your five-year survival rate actually is. Be sure to discuss what you learn about five-year survival rates with your healthcare provider. They can help you understand how this information might apply to your specific situation.
That said, any new symptom should be evaluated, so a proper diagnosis and treatment plan can be initiated promptly.
Examples of other medical conditions that may mimic that of colon cancer include:
Hemorrhoids
Hemorrhoids are swollen veins in your anus or lower rectum that may cause painless bleeding during a bowel movement and/or discomfort in the anal area.
Irritable Bowel Syndrome
Abdominal spasms and cramping are common in irritable bowel syndrome.
Appendicitis
Appendicitis refers to inflammation of the appendix, which is a finger-like structure that sticks out from your colon. Appendicitis causes severe, often sudden pain around the umbilicus that moves toward the right lower side of the abdomen. Often, it causes nausea and/or vomiting and a loss of appetite.
Diverticulitis
Diverticulitisrefers to inflammation of colon diverticulum (a pouch located in the colon wall). With diverticulitis, pain is often sudden, constant, and present in the left lower abdomen. Other associated symptoms include constipation, loss of appetite, nausea and/or vomiting.
Infectious Colitis
Bladder Infection (Cystitis)
In addition to discomfort in the suprapubic region (the area located over your pubic bone), a person with cystitis may experience symptoms like increased frequency or hesitancy with urination or burning with urination.
Kidney Stone
A kidney stone often causes pain in the lower back that may radiate to the abdomen, in addition to blood in the urine.
Colonoscopy is the “gold standard” test, and flexible sigmoidoscopy (which only looks at part of the colon) is another option. A tissue biopsy can be obtained during one of these invasive diagnostic procedures. Imaging, such as CT colography, may detect growths. Lab tests can be used to detect molecular markers for cancer or analyze stool samples for blood, andat-home colon cancer testsare a good preliminary step.
Yes.Computed tomography(CT) imaging for the colon is called CT colography or, sometimes, a virtual colonoscopy. It may be used when someone can’t tolerate a traditional colonoscopy or as part of the diagnostic process. Studies suggest CT colography isn’t as effective as colonoscopy for detecting small polyps or very early stage colon cancer, although it may, in some cases, detect polyps situated behind folds of tissue. If a CT colography reveals the presence of polyps, they will need to be removed via a colonoscopy.
Ultrasound is mainly used to see if colon cancer has spread. Three types of ultrasound imaging may be used:
How Colon Cancer Is Treated
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Davidson KW, Barry MJ, Mangione CM, et al.Screening for colorectal cancer: US preventive services task force recommendation statement.JAMA. 2021;325(19):1965. doi:10.1001/jama.2021.6238Shaukat A, Kahi CJ, Burke CA, et al.ACG clinical guidelines: colorectal cancer screening 2021.Am J Gastroenterol. 2021;116(3):458-479. doi:10.14309/ajg.0000000000001122American Cancer Society.Colorectal cancer screening tests.Wilkins T, Mcmechan D, Talukder A.Colorectal cancer screening and prevention.Am Fam Physician. 2018;97(10):658-665.Menon G, Cagir B.Colon cancer. In:StatPearls. StatPearls Publishing; 2025.American Cancer Society.Colorectal cancer.Dienstmann R, Mason MJ, Sinicrope FA, et al.Prediction of overall survival in stage II and III colon cancer beyond TNM system: a retrospective, pooled biomarker study.Ann Oncol. 2017;28(5):1023-1031. doi:10.1093/annonc/mdx052Rodriguez-Bigas MA, Lin EH, Crane CH.Colorectal cancer management. In: Kufe DW, Pollock RE, Weichselbaum RR, et al, editors.Holland-Frei Cancer Medicine.6th edition. Hamilton, ON: BC Decker.Oh KH, Han KH, Kim EJ, et al.Colon cancer after acute diverticulitis treatment.Ann Coloproctol. 2013;29(4):167-171. doi:10.3393/ac.2013.29.4.167Roswell Park Comprehensive Cancer Center.The facts about colorectal polyps.American Cancer Society.Tests to diagnose and stage colorectal cancer.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Davidson KW, Barry MJ, Mangione CM, et al.Screening for colorectal cancer: US preventive services task force recommendation statement.JAMA. 2021;325(19):1965. doi:10.1001/jama.2021.6238Shaukat A, Kahi CJ, Burke CA, et al.ACG clinical guidelines: colorectal cancer screening 2021.Am J Gastroenterol. 2021;116(3):458-479. doi:10.14309/ajg.0000000000001122American Cancer Society.Colorectal cancer screening tests.Wilkins T, Mcmechan D, Talukder A.Colorectal cancer screening and prevention.Am Fam Physician. 2018;97(10):658-665.Menon G, Cagir B.Colon cancer. In:StatPearls. StatPearls Publishing; 2025.American Cancer Society.Colorectal cancer.Dienstmann R, Mason MJ, Sinicrope FA, et al.Prediction of overall survival in stage II and III colon cancer beyond TNM system: a retrospective, pooled biomarker study.Ann Oncol. 2017;28(5):1023-1031. doi:10.1093/annonc/mdx052Rodriguez-Bigas MA, Lin EH, Crane CH.Colorectal cancer management. In: Kufe DW, Pollock RE, Weichselbaum RR, et al, editors.Holland-Frei Cancer Medicine.6th edition. Hamilton, ON: BC Decker.Oh KH, Han KH, Kim EJ, et al.Colon cancer after acute diverticulitis treatment.Ann Coloproctol. 2013;29(4):167-171. doi:10.3393/ac.2013.29.4.167Roswell Park Comprehensive Cancer Center.The facts about colorectal polyps.American Cancer Society.Tests to diagnose and stage colorectal cancer.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Davidson KW, Barry MJ, Mangione CM, et al.Screening for colorectal cancer: US preventive services task force recommendation statement.JAMA. 2021;325(19):1965. doi:10.1001/jama.2021.6238Shaukat A, Kahi CJ, Burke CA, et al.ACG clinical guidelines: colorectal cancer screening 2021.Am J Gastroenterol. 2021;116(3):458-479. doi:10.14309/ajg.0000000000001122American Cancer Society.Colorectal cancer screening tests.Wilkins T, Mcmechan D, Talukder A.Colorectal cancer screening and prevention.Am Fam Physician. 2018;97(10):658-665.Menon G, Cagir B.Colon cancer. In:StatPearls. StatPearls Publishing; 2025.American Cancer Society.Colorectal cancer.Dienstmann R, Mason MJ, Sinicrope FA, et al.Prediction of overall survival in stage II and III colon cancer beyond TNM system: a retrospective, pooled biomarker study.Ann Oncol. 2017;28(5):1023-1031. doi:10.1093/annonc/mdx052Rodriguez-Bigas MA, Lin EH, Crane CH.Colorectal cancer management. In: Kufe DW, Pollock RE, Weichselbaum RR, et al, editors.Holland-Frei Cancer Medicine.6th edition. Hamilton, ON: BC Decker.Oh KH, Han KH, Kim EJ, et al.Colon cancer after acute diverticulitis treatment.Ann Coloproctol. 2013;29(4):167-171. doi:10.3393/ac.2013.29.4.167Roswell Park Comprehensive Cancer Center.The facts about colorectal polyps.American Cancer Society.Tests to diagnose and stage colorectal cancer.
Davidson KW, Barry MJ, Mangione CM, et al.Screening for colorectal cancer: US preventive services task force recommendation statement.JAMA. 2021;325(19):1965. doi:10.1001/jama.2021.6238
Shaukat A, Kahi CJ, Burke CA, et al.ACG clinical guidelines: colorectal cancer screening 2021.Am J Gastroenterol. 2021;116(3):458-479. doi:10.14309/ajg.0000000000001122
American Cancer Society.Colorectal cancer screening tests.
Wilkins T, Mcmechan D, Talukder A.Colorectal cancer screening and prevention.Am Fam Physician. 2018;97(10):658-665.
Menon G, Cagir B.Colon cancer. In:StatPearls. StatPearls Publishing; 2025.
American Cancer Society.Colorectal cancer.
Dienstmann R, Mason MJ, Sinicrope FA, et al.Prediction of overall survival in stage II and III colon cancer beyond TNM system: a retrospective, pooled biomarker study.Ann Oncol. 2017;28(5):1023-1031. doi:10.1093/annonc/mdx052
Rodriguez-Bigas MA, Lin EH, Crane CH.Colorectal cancer management. In: Kufe DW, Pollock RE, Weichselbaum RR, et al, editors.Holland-Frei Cancer Medicine.6th edition. Hamilton, ON: BC Decker.
Oh KH, Han KH, Kim EJ, et al.Colon cancer after acute diverticulitis treatment.Ann Coloproctol. 2013;29(4):167-171. doi:10.3393/ac.2013.29.4.167
Roswell Park Comprehensive Cancer Center.The facts about colorectal polyps.
American Cancer Society.Tests to diagnose and stage colorectal cancer.
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