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Which Colorectal Cancer Screening Test Is Right For You?

Posted October 27, 2022 by Charles A. Zonfa, MD, FACOG, Senior Vice President, Chief Quality Officer, Summa

Colorectal cancer screening should be an important part of your routine health care. Screening can detect cancer and even prevent it by identifying precancerous polyps, which can be removed.

Unfortunately, too many people wait until they experience symptoms before scheduling a screening. By then, the cancer may be more difficult to treat and cure. 

Colorectal cancer, like many cancers, can be found early before it has a chance to grow and spread. Studies prove catching it early when the cancer is easier to treat improves patient outcomes. In fact, the survival rate is 91 percent when found in the early stages compared to only 14 percent when colorectal cancer is found in later stages, according to the American Cancer Society (ACS).

While a colonoscopy is considered the gold standard in detecting early colon cancer, there are several screening options available today. The ACS recommends adults at average risk aged 45 to 75 be screened for colorectal cancer. If you’re at an increased risk, however, talk to your doctor about when to begin screening and how often.

SummaCare sheds light on various options for colorectal cancer screening so you can talk to your doctor about which test is right for you and how often to be screened. But no matter which test you choose, the most important step is to get screened!

Stool tests

Stool tests are designed to check your stool for evidence of cancer. These tests are less invasive than colon visualization tests, but are done more often. They can be performed in the privacy of your home and samples are then sent to the lab for testing.

The advantages of stool tests are they don’t require sedation or a colon cleanse beforehand. However, if abnormalities are found, a follow-up colonoscopy is recommended.

The three main stool tests to screen for colorectal cancer include:

  • gFOBT: The guaiac-based Fecal Occult Blood Test is performed annually to detect blood in your stool that can’t be seen with the naked eye. Using a test kit from your doctor’s office, you can use a stick or brush to obtain a small stool sample and return the test kit to your doctor or lab for testing.
  • FIT: The Fecal Immunochemical Test is similar to the gFOBT, but instead uses antibodies to detect blood in your stool. This test is conducted annually in the same way as the gFOBT.
  • FIT-DNA: This test, also known as a Stool DNA test, combines the FIT test with one that can detect altered DNA that might indicate colon cancer and blood in your stool. For this test, you’ll need to collect an entire bowel movement to send to the lab for testing. It is recommended every three years.

Colon visualization tests

There are two main colon visualization tests: colonoscopy and virtual colonoscopy. More sensitive than stool tests, they are designed to analyze the structure of your colon and rectum for evidence of cancer. However, they are performed inside the provider’s office and require a full colon cleanse and in some cases, sedation.

  • Colonoscopy

    The colonoscopy is the most sensitive test available in detecting colon cancer. It typically takes about 30 to 60 minutes, but the drawback is it requires a full colon cleanse beforehand and sedation. 

    During the procedure, a doctor will insert a long, thin, flexible tube with a camera at the end into your rectum. This allows the doctor to check for polyps or evidence of cancer inside the rectum and your entire colon. A polyp is a growth or lesion in the tissue of the colon and most colorectal cancers begin as a polyp. During the colonoscopy, your doctor can remove polyps and some cancers if found.

    The ACS recommends a colonoscopy every 10 years if you’re not at an increased risk for colorectal cancer and no abnormalities were found during the test.

  • Virtual colonoscopy
  • Another option is a virtual colonoscopy, also known as a CT colonography. During this test, your doctor will use a CT scan to produce X-Ray images of your entire rectum and colon to analyze for polyps or cancer. A full colon cleanse is required, but it does not require sedation.

    This test usually takes about 10 minutes and is recommended every 5 years. However, if an abnormality is found, a follow-up colonoscopy might be necessary.

Which test is right for you?

Each colorectal screening test comes with its own advantages and disadvantages, so there is no one test that’s right for any person. That’s why it’s important to talk to your provider about your options and commit to a screening schedule that’s based on your personal risk factors and preferences. Remember, it doesn’t matter which test you choose as long as you get screened. The earlier colon cancer is detected, the easier it is to treat and the better your chances at surviving the disease.