When you think about colon cancer screenings, you probably think of colonoscopies, but did you know there are several other screening tests available? Deepa Shah, MD, an HonorHealth gastroenterologist, offers a quick look at colorectal cancer screening tools and how to determine which screening is best for you.
Colonoscopy
The most sensitive of colorectal cancer screenings, colonoscopies are considered the gold standard test for colon cancer.
Benefits
- The test reveals your entire colon.
- Polyps can be removed as they are found.
- It can detect other diseases and cancers.
- It's a painless, 30-minute procedure.
Drawbacks
- It's an invasive test using a colonoscope.
- Colonoscopies require a pretest diet, bowel prep and sedation.
- You'll need to miss day of work.
- You'll need someone to take you home.
- There is a small risk of bleeding, infection, perforation of colon and adverse reaction to medications.
Test frequency
- Initial screening colonoscopies are now recommended starting at age 45 and every 10 years after that until age 75 if your results are normal.
- If polyps are detected and/or you have a family history of colon cancer in a first-degree relative, you'll need to repeat the test every five years or less.
Cost/insurance
- Screening colonoscopies are more costly than other tests, but generally are covered by insurance and Medicare.
Fecal immunochemical test (FIT)
Less sensitive than colonoscopies, FIT is noninvasive and uses a stool sample you collect at home.
Benefits
- No bowel prep or sedation is needed.
- There is no direct risk to your colon.
- The test is 79% sensitive for detection of colorectal cancer and 20-50% sensitive for detection of polyps that are 10 millimeters or larger.
Drawbacks
- The test can miss polyps and some cancers.
- It can produce false-positive results.
- If your results are abnormal, a colonoscopy will be needed.
Test frequency
- You'll take this test every year, starting at age 45.
Cost/insurance
- FIT is affordable and may be covered by insurance.
Multitarget stool DNA test
This noninvasive test also uses a stool sample you collect at home.
Benefits
- No bowel prep or sedation is needed.
- There is no direct risk to your colon.
- The test is 92% sensitive for detection of colorectal cancer and 42% sensitive for detection of polyps 10 millimeters or larger.
Drawbacks
- This test can produce false-positive results.
- It can miss smaller polyps and some cancers.
- If your results are abnormal, a colonoscopy will be needed.
Test frequency
- You'll take this test every five years, starting at age 45.
Cost/insurance
- It is not covered by all insurance plans.
CT colonography/virtual colonoscopy
Virtual colonoscopies are minimally invasive but still highly sensitive.
Benefits
- This is a quick test that takes only 15 to 20 minutes.
- No sedation is needed.
- It reveals polyps as small as 1 centimeter with 90-95% accuracy.
Drawbacks
- It requires a pretest diet and bowel prep.
- 2-D and 3-D imaging requires a small amount of radiation.
- If your results are abnormal, a colonoscopy will be needed.
- Polyps can't be removed during test.
- It can produce false-positive results.
Test frequency
- You'll take this test every five years, starting at age 45.
Cost/insurance
- Insurance may or may not cover this new test.
Which screening is best for you?
"I still believe that the colonoscopy is the best because it's diagnostic and therapeutic," said Dr. Shah. However, she added, "The best test is the one that gets done."