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Investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The preferred investigations for rectal carcinoma are:

  • full blood count
  • blood film: test for iron-deficiency anaemia
  • rectal examination: palpable mass in less than 50% of cases
  • rigid sigmoidoscopy and proctoscopy: performed at the initial consultation - reveals tumours in sigmoid region and enables positive evidence by biopsy to be obtained
  • flexible sigmoidoscopy
  • stool sample: test for occult blood
  • colonoscopy: enables inspection and biopsy of the higher reaches of the colon. Gives high sensitivity if used by an experienced operator. Requires a full bowel preparation.
  • barium enema: usually reveals the tumour as a stricture or filling defect. But negative results are not uncommon, so if this occurs when the condition is suspected, repeat the investigations after a few weeks.
  • IVU: a useful preoperative investigation if there is a risk of ureteric involvement.

A barium enema and other invasive tests can be particularly distressing and should not be undertaken lightly.


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