Biloxi Woman’s Home Stool Test Was Negative Before Colon Cancer Diagnosis: Is Home Screening as Good as Colonoscopy?

Isaacs' colon cancer discovery was by happenstance, since she hadn’t experienced any concerning symptoms. When her doctor suggested she have a colonoscopy screening, they sent her an at-home kit because it was the COVID-19 pandemic, when fewer people were going into doctor's offices for preventative screenings.

We don’t know which type of test Isaacs used.

At-home screening for colon cancer include fecal immunochemical tests (FIT) that detects blood in the stool, which could be a sign that polyps (or growths) have delevoped in the colon or rectum. There’s also Cologuard, which gives you instructions on how to provide a stool sample. To complete the test, you send the stool sample back to the company, which runs some tests to see whether there are any signs of cancerous cells that can be detected in the stool.

"Many of the stool tests are good screening tools, meaning that they look for blood or pre-cancerous or cancer cells," says Dr. Heather Yeo, a colorectal surgeon at NewYork-Presbyterian/Weill Cornell Medical Center. "But they must be done more frequently. They can miss polyps and some cancer … and if [the results] are concerning a colonoscopy should be done."

"I had taken an at-home screening, and it had come back negative. I also didn't have colon cancer in my family history, so I thought I was good and didn't need one for a few years still," Lesley said.

Thankfully, her doctor insisted she still get a colonoscopy something her insurance initially didn’t want to cover because she had already taken the home test. But her attentive doctor pushed for the coverage and got Isaacs the proper screening she needed.

And it’s a good thing her doctor was insistent, because they found cancerous growths. It’s unclear whether the home test simply missed Isaacs cancer or the cancer had not developed by the time she took it.

"Thank God he did (the colonoscopy). I would have waited the three to five years that they recommended. Who knows what it would have done by then," Isaacs told WLOX news.

Knowing the Basics of Colon Cancer

Colon cancer, or colorectal cancer, is a type of cancer that affects your large intestine (colon) or the end of your intestine (rectum). It is the third-most common cancer in people of both genders in the United States, excluding skin cancers.

The cancer starts when abnormal lumps called polyps grow in the colon or rectum. If you don't have these polyps removed, they can sometimes become cancerous.  It takes up to 10 years for a colon polyp to become a full-blown cancer, according to SurvivorNet experts.

Colon Cancer Risk Factors and Symptoms

People older than 50-years-old still are at the greatest risk for colon cancer, with this age group making up about 90% of the cases.

Other risk factors of developing colon cancer include:

• Having inflammatory bowel disease.
• Having a family history of colon cancer.
• Not exercising very often.
• Eating a diet high in meat.
• Being overweight or obese.
• Using excessive alcohol and tobacco.

WATCH: How to Lower Your Risk for Colon Cancer.

Colon cancer symptoms and warning signs include:

• Change in bowel movement
• Bloody stool
• Diarrhea, constipation or feeling the bowel does not empty completely
• Unexplained weight loss
• Constant abdominal pain or cramps

If you notice concerning symptoms or changes to your body, it's important to discuss them with your doctor promptly.

Colon cancer staging takes into account the depth of the tumor in the colon, and whether the cancer has spread to the lymph nodes or to other organs, such as the liver or lungs.

• Stage 1 cancers are those in which the tumor has only penetrated the superficial layers of the colon, and haven't gotten into the deeper layers
• Stage 2 cancers involve the deeper layers of the colon wall
• Stage 3 cancers have spread to the lymph nodes around the colon
• Stage 4 cancers have spread to other organs, such as the liver, lungs, or peritoneal cavity (the space in your abdomen that holds your intestines, stomach, and liver)

Importance of Cancer and Health Screenings

Isaacs' screening that discovered her colon cancer also identified a heart blockage. Since her experience, she's now urging others to stay current with all their health screenings.

"I won't ever miss another screening test of any kind be it a colonoscopy, a mammogram, a pap smear I won't miss another one of any kind," Isaacs said.

Luckily, many cancer types have screening methods in place to help detect them early, which is key for treatment. For example, in the case of breast cancer, screenings are called mammograms.

Most colon cancers can be prevented if people are regularly screened and SurvivorNet experts recommend getting a colonoscopy rather than relying on an at-home test to get the most accurate results. The screening usually involves a colonoscopy, in which a long thin tube attached to a camera is used to examine the colon and rectum. The advantage to colonoscopy is that your doctor can remove any polyps found during the test. If no polyps are discovered, the next screening won't be needed for about 10 years.

At-home stool tests are also available in screening for colon cancer. However, our experts warn that they are not as effective as colonoscopies. Even though the at-home colon cancer test Cologuard is 93% effective that's still 7% of people who will have their cancers missed.

Colon cancers begin as polyps 95% of the time. A study published in 2014 in the New England Journal of Medicine found that the Cologuard test, for exampe, missed more than 30% of polyps that will soon become cancer, and 57% of polyps that may become cancer. That's a big discrepancy. Especially since when polyps are found during a colonoscopy, doctors can essentially stop cancer from growing before it even starts.

"We know that colon cancers can be prevented when polyps are found early," Dr. Yeo told SurvivorNet. "Lowering the screening age helps somewhat with this, but access to care is a real problem," Yeo added.

The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.

Paying for Unexpected Medical Bills

Isaacs doctor managed to appeal her health insurance's decision to deny her colonoscopy but everyone may not have the same luck. So what to do when faced with unexpected cancer-related expenses? SurvivorNet has some tips and worthy advice to help answer this question regarding cancer bills.

WATCH: How to Get Help With the Cancer Bills?

Any sum of money caused by the unexpected diagnosis of a harrowing disease can cause immense stress, but individual costs vary greatly depending upon treatment intensity and duration, survival rates and the stage of the cancer.

Medicare and private health insurance companies sometimes cover treatment costs for qualified cancer patients, but they might not cover everything. And when a claim is denied, Dr. Kristine Zanotti says it is "incumbent upon the clinician" to do something about it as was the case with Isaac's colonoscopy procedure.

Cost of cancer care affects many things, including, unfortunately, therapy options. But it's important to try to get multiple opinions after a doctor makes a treatment recommendation. Certain therapies that might be the best option for your specific cancer, however, can sometimes seem out of reach for people simply because of the cost.

No matter the treatment, it's important to know what kind of costs you'll be looking at when all is said and done. To help with that, try connecting with someone from your cancer center who can explain your share of the costs, like a patient navigator, before you decide on a therapy.

Learn more about SurvivorNet's rigorous medical review process.

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