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.
| Question | 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?