Do I Need a Colonoscopy?

Explore an at-home colon cancer screening option
African American woman thinking and filling out a form

We know that a colonoscopy is the most effective tool for the early detection and prevention of colon cancer.

But anyone who has ever had a colonoscopy also knows that it’s not necessarily something to look forward to.

“Many patients are hesitant to undergo this test because it’s invasive,” says Lisa Ravindra, MD, a primary care physician and lifestyle medicine specialist at RUSH. “A colonoscopy also requires taking time off work, a bowel preparation diet and sedation.”

The good news is you may be able to screen for colorectal cancer in the comfort of your own home.

Convenience of screening at home

At-home screening for colon cancer starts with a stool sample — no special diet or unpleasant drinks needed.

Here’s how it works: Your primary care doctor orders the test for you. You receive a small kit at your home address, along with detailed instructions. The sample is collected and mailed from your home. Once back at the lab, two tests are performed to check for signs of colon cancer and polyps.

“The first test is FIT, or fecal immunochemistry test,” says Salina Lee, MD, a gastroenterologist at RUSH. “FIT checks for tiny amounts of blood in your stool, an early sign of colon cancer. DNA-FIT combines FIT with a test for strands of DNA that could be from cancer.”

Cologuard, the brand name of the DNA-FIT test, detects 92% of colon cancers and about 42% of precancerous polyps.

Who should consider DNA-FIT tests?

Ravindra says that DNA-FIT tests can be an option for people age 45 and older with an average risk of colorectal cancer, Ravindra says. In this case, average risk means anyone who has:

  • Never had colorectal cancer or received radiation to the abdomen to treat another form of cancer
  • No family history of colon or rectal cancer
  • No hereditary or genetic problems that increase risk for colorectal cancer
  • No inflammatory bowel disease
  • No current symptoms (such as stool changes) that could mean a problem in the colon

What happens next?

“If the screening test is positive, the recommendation is to have a colonoscopy as soon as possible,” Ravindra says. “But if it’s negative, Cologuard can be done every three years.”

At RUSH, we know how important it is to get a colonoscopy after a positive Cologuard test. Our gastroenterologists are available to quickly schedule a follow-up colonoscopy.

Why doesn’t everyone get an at-home screening?

The benefits to an at-home colorectal cancer screening are obvious: skipping the bowel prep, sedation and time off work that comes with a colonoscopy.

However, Lee advises that DNA-FIT may not be right for everyone.

“A colonoscopy doesn’t just check for cancer — it can actually prevent cancer,” Lee says. “The value of a colonoscopy is that we can remove precancerous polyps that might turn into cancer given time. DNA-FIT can only detect some of these polyps, and you need a colonoscopy to detect all polyps and remove them..”

Lee and Ravindra encourage everyone to talk to their doctor about their risk for colon cancer and which screening test is best for their personal situation.

“We always say, ‘the best test is the one that gets done,’” Ravindra says.

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