Which colon cancer screening is best for me?
You’ve decided to get screened for colorectal cancer. Good for you!
Now, you and your doctor need to decide which screening method is right for you, considering your age, and your medical and family history.
You and your doctor may talk about the type of preparation that is necessary and possible sedation. Test convenience and frequency also are important to consider. Finally, the test you choose may depend on the cost and your insurance coverage.
Here’s a quick look at colon cancer screening tests and what they involve:
Colonoscopy
This test is considered the gold standard among screening methods for colorectal cancer. If results are good, you won’t need another test for 10 years. Most insurance covers it, including Medicare.
Pluses
* Most sensitive of colorectal cancer screening tests.
* Reveals entire colon.
* Removes polyps.
* Can detect other diseases and cancers.
* Painless 30-minute procedure.
Minuses
* Invasive test using a colonoscope.
* Requires pretest diet and bowel prep.
* Requires sedation.
* You have to miss a day of work.
* Driver is needed to take you home.
* Small risk of bleeding, infection, perforation of colon, adverse reaction to medications.
Fecal immunochemical test (FIT)
This test detects blood in the stool. You may choose this yearly, home-based test if you want to avoid the bowel prep and sedation required for a colonoscopy.
The test should be done every year after age 50. It’s affordable and may be covered by your insurance.
Pluses
* Noninvasive test.
* Stool sample is taken at home.
* No bowel prep required.
* No sedation required.
* No direct risk to colon.
* 79 percent sensitive for detection of colorectal cancer.
* 20 to 50 percent sensitive for detection of polyps that are 10 millimeters or larger.
Minuses
* Can miss polyps and some cancers.
* Can produce false-positive results.
* If results are abnormal, colonoscopy will be needed.
Multitarget stool DNA test
This test not only detects mutations associated with cancer in the stool, it also incorporates the FIT test to detect hidden blood. You may choose this test if you want to avoid the prep and sedation required for a colonoscopy.
You’ll need to take this test every five years, starting at age 50. It’s not covered by all insurance plans.
Pluses
* Noninvasive test.
* Sample (entire stool) is taken at home.
* No bowel prep required.
* No sedation required.
* No direct risk to colon.
* 92 percent sensitive for detection of colorectal cancer.
* 42 percent sensitive for detection of polyps 10 millimeters or larger.
Minuses
* Can produce false-positive results.
* Can miss smaller polyps and some cancers.
* If abnormal results, colonoscopy will be needed.
CT colonography/virtual colonoscopy
This minimally invasive screening test uses 2-D and 3-D imaging to view your colon. It’s an alternative to a colonoscopy for individuals on blood thinners or anti-coagulants because of heart issues. Doctors also prescribe the test for frail elderly people and those with breathing problems.
Doctors recommend this test every five years, starting at age 50. Because it’s fairly new, your insurance may not cover it.
Pluses
* Minimally invasive test.
* Quick test — 15 to 20 minutes.
* No sedation required.
* Reveals polyps as small as 1 centimeter with 90 to 95 percent accuracy.
Minuses
* Requires pretest diet and bowel prep.
* 2-D and 3-D imaging requires small amount of radiation.
* If abnormal results, colonoscopy will be needed.
* Can’t remove polyps during test.
* Can produce false-positive results.
No matter which colorectal cancer screening method you choose, “the best screening test is the one that gets done,” said HonorHealth gastroenterologist Deepa Shah, MD.
If you need a screening test, find a gastroenterologist with HonorHealth.
