Colonoscopy alternatives: know your options

Let’s face it: Colonoscopies aren't exactly pleasant. Whether it’s the prep needed beforehand, the perceived pain or embarrassment while getting one, or the fear of finding out that they have colon cancer, people will find reasons to avoid getting screened¹ as patient surveys show.

Not to say that these concerns should be dismissed – they are real and more than valid. Still, it does not change the fact that colon cancer is the third most common cancer among men and women.²

Since 1994, there has been a 51% increase in colon cancer rates in adults under the age of 50.³ This is one reason why the  American Cancer Society (ACS) recommends that people with average risk start screening at age 45.³

Not all facts about colon cancer are gloom and doom, though. Do you know that it is the most preventable, yet the least prevented cancer?⁴ Also, when caught in its early stages, it’s survivable in about 90% of people.^*5 This means that early detection through timely screening can make a world of difference when it comes to treatment and recovery.

Is there a way to screen for colon cancer without a colonoscopy? Good question — and for people at average risk, the answer is yes. There are options that are noninvasive, require little to no prep, and you can do them at your own pace, in your own space. Let’s review each of them so you can decide what works best for you.

One more thing: whatever test you choose, please know that if it yields a positive result, you will need to follow it up with a colonoscopy.

Colonoscopy

What it is:

• A flexible tube with a camera at its tip called a colonoscope is inserted into the rectum
• The camera will show the inside of your colon, so the operator can identify any polyps (small growths) inside it
• These polyps, along with any biopsy (tissue samples), can be removed during the procedure

Requirements:

• A complete colon cleanse with bowel prep (laxatives)
• A low-fiber diet two to three days before, followed by a liquids-only diet the day before
• Sedation before the procedure

Virtual Colonoscopy

What it is: 

• Also known as a CT colonography
• Less invasive than a colonoscopy
• Uses a CT scan to capture detailed images of the colon and rectum for polyps
• No sedation is needed

Requirements:

• A complete colon cleanse with medications
• A liquids-only diet the day before
• Fasting (no food or drink) a few hours before the procedure

Fecal immunochemical test (FIT):

What it is:

• An over-the-counter test that detects occult (hidden) blood in the stool
• Blood in the stool can be a sign of precancerous polyps or colon cancer
• Noninvasive and can be used at home, but a stool sample needs to be sent back to the lab for testing
• A positive result requires a colonoscopy

Requirements:

• No prep or special diet is required
• No medication is required
• No downtime

Guaiac-based fecal occult blood test (gFOBT):

What it is:

• Just like a FIT, a gFOBT is an over-the-counter test that detects occult blood in the stool
• Uses guaiac, a chemical that can detect blood up the digestive track, including the stomach
• Noninvasive and can be used at home, but stool samples need to be sent back to the lab for testing
• A positive result requires a colonoscopy

Requirements:

• NSAIDs such as naproxen, ibuprofen, or aspirin should not be taken 7 days before testing
• Vitamin C in fruits or supplements should be avoided 3 days before testing
• Red meat, as well as raw fruits and vegetables, are not allowed
• Because it needs at least 3 bowel movements, a single test can take a few days to complete

Cologuard^® Stool DNA test

What it is:

• Currently, the only FDA-approved stool DNA test is Cologuard
• Noninvasive and prescription-based, it finds abnormal DNA from cells, as well as tiny amounts of blood in the stool, to detect cancer and precancer
• Can be used at home, but a stool sample needs to be sent back to the lab for testing
• A positive result requires a colonoscopy

Requirements:

• No prep or special diet are required
• No medication is required
• No downtime

All of these tests are available for people 45+ with an average risk for colon cancer. If you’re still hesitant to screen, know that you’re not alone, and it’s okay to feel that way. Have an honest conversation with your doctor to see what would work best for you and your needs. Whatever method you choose, be proud of yourself for taking the first crucial step in fighting this preventable disease.