How to Choose a Colorectal Cancer Screening Test

Why should I get screened in the first place!

Colon cancer is the third leading cause of cancer death in men and women in the United States. Studies show that screening with colonoscopy and removing pre-cancerous polyps before they cause a problem down the road has been shown to effectively reduce rates of colorectal cancer.

Who should be screened for colorectal cancer?

Physicians recommend that most people start getting screened for colorectal cancer at age 45, or 50 depending on your insurance. If you have a strong family history of colon cancer or polyps, you may need to start even earlier.  Most people can stop being screened around age 75-85.

What screening tests are out there?

Every test has its positives and negatives, but colonoscopy is still considered the “gold standard”.

  1. Colonoscopy: A colonoscopy allows your doctor to see directly inside your colon and look for any polyps that can eventually turn into colon cancer. It can find small and large polyps and remove them right away in most cases. If you get a colonoscopy as your first test, you won’t likely need another test for a while. Colonoscopies do have risks like bleeding or tearing inside of the colon, but this is rare.
  2. Virtual Colonoscopy: This looks for large polyps and cancers using a special X-ray called a “CT Scan.” However, you still need to do a bowel preparation to clean your colon out. Also, these tests are not readily available and you may have to travel far to get one done. They can also be quite expensive and sometimes insurance may not cover it as a screening test. The advantage is that you don’t need anesthesia to get this test done. Also, if they do find an area that doesn’t look normal, you may still need a colonoscopy to look at your colon and see what exactly is going on. Also, with this test you are exposed to radiation.
  3. Stool test for blood– Stool tests most commonly check for blood in samples of stool. Cancers and polyps can bleed, and if they bleed around the time you do the stool test, then blood will show up on the test. The test can find even small amounts of blood that you can’t see in your stool. Other less serious conditions can also cause small amounts of blood in the stool, and that will show up in this test. You will have to collect small samples from your bowel movements, which you will put in a special container you get from your doctor or nurse. Then you follow the instructions to mail the container out for the testing. The drawback to this test is that if there is something abnormal, you will still likely need a colonoscopy.
  4. Stool DNA test – The stool DNA test checks for genetic markers of cancer, as well as for signs of blood. For this test, you get a special kit in order to collect a whole bowel movement. The advantages to this test are that you do not have to clean out your colon or have a procedure. However, if it is abnormal, it will usually need to be followed up with a colonoscopy. Also, it is important to note that much of the time, insurance companies will count this as your screening test for colon cancer, and not fully cover the cost of a colonoscopy should you need one.