Once you turn 45, regular colon cancer screening is crucial for early detection and prevention of one of the most common and potentially life-threatening cancers.
This table compares available screening tools to help you make an informed decision about the screening method that best suits your needs and preferences. Once you’re ready to select your screening option, click the “I’ve made my decision” button below.
Colonoscopy | iFOB/FIT (fecal immunochemical test) | FIT/DNA (Cologuard) | |
|---|---|---|---|
| Effectiveness What does this mean? | Tier 1 | Tier 1 | Tier 2 |
| Who is it for? What’s my risk level? | Individuals at high or average risk | Individuals at average risk | Individuals at average risk |
| How does it work? | Uses a thin, flexible, lighted tube with a lens for viewing the colon/rectum and a tool for removing abnormal growths (polyps) | Detects blood in a stool sample | Detects blood and abnormal DNA in a stool sample |
| Preparation | Preparation includes a liquid diet and the use of a bowel-cleansing laxative drink | No preparation; stool sample collected at home | No preparation; stool sample collected at home |
| Accuracy | Detects approximately 95% of all colorectal cancers. | Detects approximately 90% of all colorectal cancers and advanced precancerous polyps. | Detects more than 90% of all colorectal cancers but only 42% of advanced precancerous polyps. |
| Frequency | Every 10 years if normal | Every year if normal | Every three years if normal |
| Advantages | Can both detect and remove polyps, which has been shown to decrease colon cancer mortality | Easy, safe, and convenient | Easy, safe, and convenient |
| Disadvantages |
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EFFECTIVENESS
The U.S. Multi-Society Task Force of Colorectal Cancer and The American Society for Gastrointestinal Endoscopy have ranked colorectal cancer screening tests based on performance features, costs, and practical considerations. First-tier tests are the most highly recommended; lower-tier tests have disadvantages relative to Tier 1 tests.
RISK LEVEL
If you can answer “yes” to any of the following questions, you are at high risk for colorectal cancer and should schedule a colonoscopy:
- Have you experienced any episode of blood in your stool or bleeding when you have a bowel movement?
- Was a polyp detected on a previous colonoscopy?
- Do you have a history of inflammatory bowel disease (Crohn’s disease or ulcerative colitis)?
- Has any first-degree relative (your parent, sibling or child) had colon cancer?
- Has any first-degree relative (your parent, sibling, or child) had a colon polyp before age 60?
- Do you have a family history of a genetic syndrome that increases cancer risk?