At-Home Colon Cancer Tests vs. Colonoscopies

No one likes to think about colorectal cancer, a disease that can attack the colon, rectum or both. But think about this: Colorectal cancer is the second-leading cause of cancer-related deaths in the United States. It’s also one of the most preventable cancers.

The best way to screen for colorectal cancer is with a colonoscopy. While the procedure itself is painless, the biggest hassle is the prep, which often involves a liquid diet and using laxatives before the screening. Still, colonoscopies are considered the gold standard for colorectal cancer screening. These tests can detect cancer in its earliest stages, and doctors can remove potential cancers during the exam, preventing the disease from forming.

However, it is not the only screening available. In recent years, at-home tests have made colorectal cancer screening more convenient, begging the question, are they a better alternative to a colonoscopy?

Read More: Colorectal Cancer: A Growing Risk for Young Adults

At-Home Colorectal Cancer Screening: Pros and Cons

The biggest advantage to using an at-home test (Cologuard^® is a frequently advertised example) is that you don’t need to do any kind of prep.

“At-home tests are noninvasive, you’re not sedated and you don’t need to take a day off work,” says Dr. Richard Stewart, board-certified gastroenterologist at Beaufort Memorial Lowcountry Medical Group. “However, you need to retake the test every three years, whereas if you’re at average risk, you need a colonoscopy only once every 10 years.”

It’s important to note that some noninvasive colonoscopy alternatives are better than others in detecting cancers.

“For instance, fecal immunochemical test (FIT) screening only detects blood in the stool and misses 20% of colorectal cancers,” Dr. Stewart says. “Cologuard, for example, tests for blood, DNA mutations and other biomarkers — and is more sensitive.”

Dr. Stewart adds that there are more false-negative results with at-home tests than with colonoscopies. False negative results suggest that cancer is absent, when it really isn’t. As a result, at-home tests are less likely than colonoscopies to find cancer.

In addition, people who opt for at-home screenings may not be able to avoid colonoscopies entirely. If an at-home test is positive, you will need to have a colonoscopy.

Who Should Opt for a Colonoscopy?

With colorectal cancer, early detection leads to better outcomes. So if you have any of the following risk factors, your doctor will most likely recommend you have a colonoscopy rather than using an at-home test:

• A personal history of previous polyps
• Personal history of colorectal cancer, inflammatory bowel disease, or radiation to the abdomen
• A strong family history of colorectal cancer or syndromes linked to colorectal cancer, such as Lynch syndrome.

Read More: How to Prep for a Colonoscopy

The American Cancer Society recommends that adults at average risk for colorectal cancer begin screenings at age 45 and continue screening once every 10 years until age 75. Having multiple first-degree relatives — parents or siblings — with colon cancer or one who had colon cancer before age 50 suggests a possible hereditary colon cancer syndrome and may require earlier screening.

To schedule an appointment with a Beaufort Memorial Lowcountry Medical Group gastroenterologist, call 843-770-4588.