Specific investigations for right-sided cancer

There are a series of specific investigations for right-sided colonic carcinoma:

• stools: positive for occult blood
• blood film: detect iron deficiency anaemia
• erythrocyte sedimentation rate (ESR): raised
• barium enema:
  • lesions appear as a constriction or intraluminal mass
  • false negatives are not uncommon
  • if a negative result obtained when carcinoma suspected, repeat after a few weeks
• colonoscopy:
  • may miss lesions greater than 5 mm diameter that can be hidden around folds or in flexures;
  • barium enema may miss about 20% of neoplastic lesions greater than 5 mm diameter which are seen on colonoscopy