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Colorectal cancer screening: Which test is right for you?

Posted March 07, 2022 by Truong Ma, M.D.

graphic of a colon

As the third leading cause of cancer-related death in both men and women in the U.S., screening for colorectal cancer should be an important part of your routine healthcare.

Colon and rectal cancers, more commonly known as colorectal cancer, can be found early with testing before it has a chance to grow and spread. And studies prove catching it early when the cancer is easier to treat improves patient outcomes.

Just look at the survival rate for colorectal cancer as proof. According to the American Cancer Society (ACS), the survival rate is 91 percent when found in the early stages compared to only 14 percent when colorectal cancer is found in later stages.

ACS recommends adults at average risk start screening for colorectal cancer at age 45. If you’re at an increased risk, however, talk to your doctor about when to begin screening and how often.

While a colonoscopy is considered the gold standard in detecting early colon and rectal cancers, there are several screening options available today. Each comes with advantages and recommendations how often they are recommended.

Summa Health discusses the various options for colorectal cancer screening so you can talk to your healthcare provider about which test is right for you and how often to be screened. But no matter which test you choose, the most important step is to get screened!

Stool tests

Stool tests are designed to check your stool for evidence of cancer. These tests can be performed in the privacy of your home and samples are then sent to the lab for testing. The advantages of stool tests are they don’t require sedation or a colon cleanse beforehand.

However, if abnormalities are found, additional testing with a colonoscopy will likely be needed.

The three main stool tests to screen for colorectal cancer include:

  • gFOBT: The guaiac-based Fecal Occult Blood Test is performed to detect blood in your stool that can’t be seen with the naked eye. Using a test kit from your doctor’s office, you can use a stick or brush to obtain a small stool sample and return the test kit to your doctor or lab for testing. This test is recommended every year.
  • FIT: The Fecal Immunochemical Test is similar to the gFOBT, but instead uses antibodies to detect blood in your stool. This test is conducted in the same way as the gFOBT and is recommended annually, as well.
  • FIT-DNA: This test, also known as a Stool DNA test, combines the FIT test with one that can detect altered DNA that might indicate colon cancer and blood in your stool. For this test, you’ll need to collect an entire bowel movement to send to the lab for testing. It is recommended every three years.

Colon visualization tests

Colon visualization tests are designed to analyze your colon for evidence of cancer and are more sensitive than stool tests. However, they are performed inside the doctor’s office and require a full colon cleanse and in some cases, sedation.


The colonoscopy is the most sensitive test available in detecting colon cancer. It typically takes about 30 to 60 minutes.

During the procedure, a doctor will insert a long, thin, flexible tube with a camera at the end into your rectum. This allows the doctor to check for polyps or evidence of cancer inside the rectum and your entire colon. A polyp is a growth or lesion in the tissue of the colon and most colorectal cancers begin as a polyp. During the colonoscopy, your doctor can remove polyps  if found.

The ACS recommends a colonoscopy every 10 years if you’re not at an increased risk for colorectal cancer and no abnormalities were found during the test.

Virtual colonoscopy

Another option is a virtual colonoscopy, also known as a CT colonography. During this test, your doctor will use a CT scan to produce X-Ray images of your entire rectum and colon to analyze for polyps or cancer. A full colon cleanse is required, but it does not require sedation.

This test usually takes about 10 minutes and is recommended every 5 years. However, if an abnormality is found, a follow-up colonoscopy might be necessary.

Which test is right for you?

Each test comes with its own advantages so it’s best to talk to your healthcare provider about your options and commit to a screening schedule that’s based on your personal risk factors and preferences. Remember, it doesn’t matter which test you choose as long as you get screened. The earlier colon and rectal cancers, or polyps that could develop into cancer are detected, the easier it is to treat and the better your chances of surviving the disease.

Truong D Ma, MD

Truong D Ma, MD

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