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Alternatives to getting a colonoscopy to screen for cancer

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Posted at 12:00 PM, Feb 26, 2020
and last updated 2020-02-26 16:11:35-05

It’s a right of passage when you hit a certain age: get a colonoscopy but for many people the thought of that test is scary.

From the preparation to the actual procedure many people are concerned it will be unpleasant and just don’t want to do it.

While it is the most effective way to test for colorectal cancer, there are other options.

Dr. David Stein, the Regional Chief of Surgery for MedStar Health and Chairman of Surgery at MedStar Franklin Square Medical Center, specializes in colon and rectal surgery.

“The message is that it is not the only screening test and it’s much more important to get screened.”

You can buy several different kits to test your stool at home. They are sold over the counter and you can even find them online.

The Guaiac FOBT test uses a chemical to detect a component of hemoglobin, a blood protein in the stool. You take a sample from your stool and mail the results back to the lab.

Dr. Stein says no matter what the result shows it’s important to send back those results and to talk to your doctor.

Another option is the fecal immunochemical test. This test looks for hidden blood in your stool. Dr. Stein says one of the negatives to this test is once blood is detected in the stool it usually means that the cancer is more advanced.

Both tests must be done once a year.

A third home test option is called the multi-target stool DNA test. It detects trace amounts of blood and DNA from cancer cells in the stool. It requires you to mail your stool to the lab where they do the test.

The kit includes everything you need to properly ship the sample and needs to be done every 3 years.

Dr. Stein says many people choose these types of tests because they are non-invasive, and you don’t need to do any bowel prep.

“There is nothing wrong with saying ‘I’m not getting a colonoscopy.’ I’m doing a stool test.”

Another option to screen for colorectal cancer is a CT/MRI scan to look for growths on the colon.

Dr. Stein says one of the downsides to this is you still need to go through the same bowel prep you would go through if you were getting a colonoscopy.

The doctor inflates your colon with a puff of air and then looks at the images to see if there is anything concerning. If they do see something, you would then need to get a colonoscopy.

Assuming the test comes back clean, it needs to be done every 5 years.

A sigmoidoscopy is another less invasive way to screen for colorectal cancer than a colonoscopy.

There is less bowel prep and typically patients do not need to be sedated for the procedure. This test is similar to a colonoscopy but it only checks the lower part of the colon.

If a polyp or cancer is found, you would need to have a colonoscopy to look at the rest of the colon. This test needs to be done every 5 years.

A colonoscopy is done every 10 years starting at age 45 for a healthy adult.

Dr. Stein says it is still the most effective way to screen for colorectal cancer. He said this test is best at detecting polyps that other tests wouldn’t pick up.

It is also the most effective at catching cancer at its earliest stage.

“It’s better to have a test even if you don’t want a colonoscopy,” said Dr. Stein.

“The most important thing you can do is talk to your doctor about screening tests because a screening test by definition is ‘I don’t have symptoms.”