Most medical professionals recommend the use of a colonoscopy for colon cancer screening. Unfortunately, the procedure can be costly and feel invasive, which leads some people to avoid it.
In this article, we look at other tests used for colon cancer screenings that people may want to consider if they are reluctant to have a colonoscopy.
A colonoscopy is used to check the large intestine and colon for abnormalities.
During this procedure, a long tube called a colonoscope is inserted into the rectum and travels up along the length of the colon.
The colonoscope transmits pictures, which are used to search for intestinal polyps. If a doctor finds a polyp, it will be cut out using a small wire loop on the tube.
Though a colonoscopy offers possible life-saving benefits against colon cancer, some people choose to opt out of the procedure for the following reasons:
- It requires a full day's preparation, including a bland diet, a prescribed drink to induce diarrhea for colon cleaning, and sometimes an enema to clean out the colon even further.
- It requires sedation. When they wake up afterward, the person will probably feel pressure from gas that may have been forced into the colon.
- As well as feeling nervous about the physical discomfort, a person may worry about the high cost of a colonoscopy. For people with little or no health insurance, this can be a deterrent.
The reluctance to have a colonoscopy can be a worrying health concern. Colonoscopies have been proven to help save lives, as increased colonoscopy rates show a decline in colon cancer-related deaths.
However, the cost and discomfort of the procedure have led some people to avoid screening. Doctors and researchers are beginning to offer alternatives to a colonoscopy.
There are several tests available that can be alternatives to a colonoscopy. All of these tests differ in their effectiveness in detecting colon cancer.
While a colonoscopy may be the best option, alternative tests can help a person reduce their colon cancer risk if they are unable or unwilling to have a colonoscopy.
1. Fecal Immunochemical Tests
Fecal Immunochemical Tests (FIT) are a common screening choice in many areas of the world, and the United States Food and Drug Administration (FDA) approve their use.
FITs use antibodies to detect blood in a person's stool that cannot be seen with the naked eye.
A FIT checks for internal gastrointestinal bleeding. To reduce the chance of a false positive, a person should tell their doctor if they have hemorrhoids or anal fissures, or they are menstruating.
A person is given a kit to collect a fecal sample at home. The FIT is covered by most insurance companies and is a low-cost test. However, it needs to be repeated every year.
If a FIT identifies abnormalities, a colonoscopy may be recommended. When used yearly, a FIT can be just as effective as a colonoscopy.
2. Double-contrast barium enema
A double-contrast barium enema is a type of X-ray used to examine the colon. The test can be effective in detecting large colon polyps, but it may miss small ones.
Similarly to a colonoscopy, it requires the colon be completely cleaned with fasting and evacuation of the bowel.
If a suspicious patch is found in the colon, it is likely its removal will still require the person to have a colonoscopy.
3. Fecal occult blood tests
A fecal occult blood tests (FOBT) can be as effective as a colonoscopy, but it needs to be done every year in order to guarantee effectiveness.
This test combines a blood test with the FIT to get an accurate detection of colon cancer.
Cologuard is another stool test that can be used in place of a colonoscopy. This relatively new test is more expensive than the FIT, but it is covered by private insurance in most cases.
When used instead of a colonoscopy, the cologuard test should be used every 3 years.
5. Stool DNA
A stool DNA test is a prescribed test that can be done at home. This test looks for blood and certain DNA in the stool sample that may indicate the presence of colon cancer.
If cancer is detected, the person will need to have a colonoscopy to remove the cancerous growth.
6. CT colonoscopy
A CT colonoscopy involves taking an X-ray of the colon. Similarly to the colonoscopy, the colon will need to be emptied beforehand.
A person does not need to be sedated during a CT colonoscopy. During the procedure, the colon is inflated with air to provides a better view of the inside.
If a polyp or cancer is found, a colonoscopy will be required to remove the harmful tissues.
A sigmoidoscope is a similar test to a colonoscopy but checks a smaller portion of the colon only. As with a colonoscopy, it requires intensive preparation, including fasting and cleansing the colon.
As the sigmoidoscope only checks a small portion of the colon but requires the same preparation and discomfort, it is not often recommended and may not be a desirable alternative.
A colonoscopy is primarily used to find cancerous and precancerous growths in the colon. It is usually considered effective in early detection of colorectal cancer.
Colorectal cancer is slow-growing cancer that can be effectively treated when caught early.
Experts consider fecal testing, colonoscopy, and sigmoidoscopy effective methords of screening, but fecal testing is the least invasive option.
Fecal testing and sigmoidoscopies are as good as colonoscopies at reducing the mortality rate of colorectal cancer.
However, fecal studies cannot prevent colorectal cancer. They can only help a doctor detect it once it is there.
Colonoscopies and sigmoidoscopies can help prevent colorectal cancer by finding adenomas, which appear before a tumor develops.
A doctor may ask a person which option they prefer. Some people prefer a fecal test because it is less invasive. However, those concerned with preventing cancer may prefer a colonoscopy or sigmoidoscopy.
The American College of Physicians recommend the following as options for screening for adults with an average risk of colorectal cancer between the ages of 50 and 75 years:
- fecal testing every 2 years
- a colonoscopy every 10 years
- a sigmoidoscopy every 10 years plus fecal testing every 2 years
When done as recommended, alternatives to colonoscopies can be just as effective as a colonoscopy in detecting colon cancer. However, if any abnormalities are found, people may require a colonoscopy anyway.
It is necessary for all people to understand the importance of getting a colon screening past the age 50.
Although a colonoscopy may be the most effective test, any screening is better than none, and the alternatives should be considered when a colonoscopy is not desired.