Although Less Comfortable, Colonoscopies Remain Irreplaceable
- A new study evaluating the fecal immunochemical test (FIT), an at-home colorectal cancer screening test kit, is less effective, noting roughly 10 percent are mainly unusable for patient-related reasons.
- Colonoscopies are the most effective way to screen for colon cancer, according to our experts.
- A study found that one brand of home screening missed more than 30% of polyps that will soon become cancer and 57% of polyps that may become cancer.
- The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.
- The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
- Colon cancer, or colorectal cancer, affects your large intestine (colon) or the end of your intestine (rectum).
Colorectal cancer screening can be an uncomfortable experience for people with a colonoscopy on their to-do list. Since coloscopies are often undesirable, at-home colorectal cancer screening kits have emerged to help make the process easier to bear. However, a new study suggests that at-home colorectal cancer screening, such as the fecal immunochemical test (FIT) kit, is not as effective, leading to inconclusive results.
Expert Resources for Colon Cancer Screening
- Colon Cancer Screening Options And Genetics: Myth Busting With Dr. Heather Yeo
- Colon Cancer Screening is Extremely Important; Guidelines Now Say to Start at Age 45 if There Is No Family History
- Colorectal Cancer Screening: a New Study Questions the Effectiveness of Colonoscopies But Specialists Reinforce its Importance
RELATED: Colon Cancer Screening Options and Genetics
WATCH: Effectiveness of Colonoscopies
Are Colonoscopy Alternatives Better? Many Experts Say “No”
Most colon cancers can be prevented if people are regularly screened. SurvivorNet experts recommend getting a colonoscopy rather than relying on an at-home test for 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 of colonoscopy is that your doctor can remove any polyps found during the test. If no polyps are discovered, the following screening won’t be needed for about ten years.
At-home stool tests are also available to screen 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 example, missed more than 30% of polyps that will soon become cancer and 57% of polyps that may become cancer. That’s a significant 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.
Dr. Zuri Murrell, a colorectal cancer surgeon and Director of the Cedars-Sinai Colorectal Cancer Center, previously explained the colonoscopy procedure to SurvivorNet.
“When we see a polyp, we actually physically take the polyp out through the colonoscope,” he explained.
“What does that mean? That means we basically put a wire through with a little bit of a flange at the end, and we pull the polyp out. Now, note there is no pain with that. Inside the colon, there are no pain fibers. So, there’s no pain,” Dr. Murrell added.
The advantage of a colonoscopy is that your doctor can remove any polyps found during the test. Many colon cancers can be caught on colonoscopy before they develop or when the polyps are small enough to be removed without surgery.
RELATED: Myth Busting: Let’s Talk About Colon Cancer Screening
When to Screen for Colon Cancer?
The American Gastrointestinal Association lowered the recommended initial age for a colorectal screening from 50 to 45.
The U.S. Preventive Services Task Force recommends guidelines that state colon cancer screenings should begin at 45 years old. This is in response to the increase we see in colon cancer diagnoses in younger adults. However, many insurance companies still do not cover the cost of screenings for those under 50. In the past, the disease had predominantly been found in adults 50 years or older, but for those predisposed to getting it at a younger age, these new guidelines could help catch it earlier.
The best and most complete way of screening is a colonoscopy every ten years. You should get your first colonoscopy at age 45, but the guidelines differ depending on your risk category. If you have a close relative who has colon cancer, a rule of thumb is to get screened ten years before their age of diagnosis to make sure any growths or cancers are caught early. If you have several family members who had colon cancer or family members who got it at a young age (less than 50 years old), it may be necessary to undergo genetic screening. If you have a lot of polyps on your colonoscopy or if you have had colon cancer previously, you will need a colonoscopy every 3 to 5 years.
Questions to Ask Your Doctor
If you are facing a colon cancer diagnosis, here are some questions you may ask your doctor.
- What are my treatment options based on my diagnosis?
- If I’m worried about managing the costs of cancer care, who can help me?
- What support services are available to me? To my family?
- Could this treatment affect my sex life? If so, how and for how long?
- What are the risks and possible side effects of treatment?
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