Colon cancer screening options

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Which colon screening is the best for me?

You may think of colonoscopy when you think about colon cancer screening tests. However, there are a number of newer tests available. Deepa Shah, MD, an HonorHealth gastroenterologist, offers a quick look at colorectal cancer screening tools.

Which screening is the best for me?

Colonoscopy

Pluses

  • Most sensitive of colorectal cancer screening tests.
  • Considered the gold standard of screening tests for colon cancer.
  • 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.
  • Miss day of work.
  • Driver needed to take you home.
  • Small risk of bleeding, infection, perforation of colon, adverse reaction to medications.

Test frequency

  • If results are good, every 10 years, starting at age 50.
  • Five years or less if polyps are detected and/or you have a family history of colon cancer in a first-degree relative.

Cost/insurance

  • Screening colonoscopies are more costly than other tests, but generally are covered by insurance and Medicare.

Fecal immunochemical test (FIT)

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 CRC.
  • 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 abnormal results, colonoscopy will be needed.

Test frequency

  • Every year, starting at age 50.

Cost/insurance

  • Affordable. May be covered by insurance.

Multitarget stool DNA test

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.

Test frequency

  • Every five years, starting at age 50.

Cost/insurance

  • Not covered by all insurance plans.

CT colonography/virtual colonoscopy

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.

Test frequency

  • Every five years, starting at age 50.

Cost/insurance

  • Could have insurance issues because it’s fairly new.

Which test is right for you? "I still believe that the colonoscopy is the best," said Dr. Shah, "because it's diagnostic and therapeutic." However, she added, "The best test is the one that gets done."

Find a gastroenterologist in the greater Phoenix area or call 623-580-5800.