Colonoscopies aren’t the only way to screen for colorectal cancer. Several convenient at-home and in-office options are available for average-risk patients.
Finding colorectal (colon and rectal) cancer in early stages is important for surviving the disease. On-time screening for colorectal cancer can find cancer before it spreads, or even stop cancer from starting. When found early, colorectal cancer is much easier to treat successfully.
Average-risk Americans should begin screening for colorectal cancer at age 45. After that, they should continue to be screened based on their doctor’s recommendation. Average risk means being 45 or older, with no family history of colon cancer or polyps, and no symptoms.
Beyond the colonoscopy
Most people are familiar with colonoscopies, a common screening test for colorectal cancer. Many people also feel nervous about a colonoscopy because of stories they have heard about the test or the prep. The good news is that there are several other noninvasive options for average-risk patients who may struggle to complete a colonoscopy.
Noninvasive screening options are simple, require no prep or time off work, and can even be done at home. If one of these tests shows a problem, a follow-up colonoscopy will still be needed.
Your noninvasive options
FIT screening checks for hidden blood in your stool. A small swab of your stool is taken and sent to a lab for testing. A FIT screening should be done once a year. This test can detect blood from a polyp or cancer, but it can also detect bleeding from other causes.
There are also stool tests like Cologuard and ColoSense. These tests are sent to your home and require a larger sample of your stool to be sent back to the lab for further testing. The lab examines the sample for blood as well as genetic markers (DNA or RNA) for precancerous polyps and colorectal cancer. These tests require a prescription from a doctor and must be completed every three years. If abnormal results are found, a follow-up colonoscopy is needed.
A blood test is also available that can be done during a regular doctor’s visit. This blood test looks for signs of colon cancer from DNA shed into the blood. This screening option may be most appropriate for average-risk adults who will not complete other types of colorectal screening, or for patients with health issues that make other colorectal cancer screening difficult.
Know the differences
Not all colorectal cancer screening options find cancer at the same rates. Some are more efficient at detecting later-stage cancers rather than early-stage cancer or polyps. Stool-based boxed tests may find some growths (polyps) inside the colon that may develop into cancer over time, while FIT and blood-based screening are most effective at finding late-stage cancer. Unfortunately, this means FIT and blood screening may miss many early-stage cancers, polyps, and advanced adenomas.
The most important thing to remember is this: There are many ways to be screened for colorectal cancer. Don’t wait until age 45 to talk to your doctor about your risk and the best test for you.
