Endoscopic View of Rectal Adenocarcinoma Evaluation begins with a history and physical examination, including a digital rectal examination. Inspect the stool and test for occult blood. Order blood tests (ie, complete blood count, liver function tests, and carcinoembryonic antigen levels) Perform complete colonoscopy looking for syncronic adenonocarcinoma or polyps.Colonoscopy, which has been found to be more accurate in detecting synchronous neoplasms, should be included in the evaluation of all patients with colorectal cancers. Perform CT studies to stage the tumor before treatment and to choose the most appropriate treatment. Although magnetic resonance imaging (MRI) is slightly more accurate than CT in staging primary rectal tumors, CT is much more widely available. Most institutions and departments have more extensive experience using CT than MRI and continue to use CT for staging rectal tumors. This may change in the future.
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