At-Home Alternatives To Colonoscopy

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At-home health screening tests today cover everything from testing for high cholesterol to urinary tract infections – and even colon cancer.

So when it comes to colon cancer, are at-home test as good as colonoscopy, which is the gold standard for colorectal screening, colon polyp removal and early cancer detection?

“The at-home screening test for colon cancer prescribed by physicians can definitely reduce your risk of colon cancer. But, at best, they’re only half as effective as colonoscopy,” says Craig Reickert, M.D., a colorectal surgeon at Henry Ford Health.

Still when it comes to choosing between an at-home test and colonoscopy, Dr. Reickert says: “The only bad option is not checking at all for colon cancer.”

According to the American Cancer Society, colorectal cancer is the third most common cancer in the U.S., affecting more than 135,000 people each year.

At-home testing options

There are now three options for at-home colon cancer tests. All three are prescribed by a physician; they’re not available over-the-counter. They are:

  • Fecal occult blood test (FOBT) and fecal immunochemical test (FIT). Both look to find tiny amounts of blood in the stool that could be a sign of colon cancer or large polyps. For FOBT and FIT, you swab your stool on a card over the course of several days and mail it to the lab. “Doing a fecal occult blood test or FIT every year is certainly shown to reduce your risk of dying from colon and rectal cancer,” says Dr. Reickert.
  • Cologuard. This is the newest option available to patients. With Cologuard, you collect your stool in a kit provided by your physician and ship it to the lab. If your results are normal, Cologuard can be used every three to four years. “Cologuard is very good at finding cancer cells,” says Dr. Reickert, “but it does not do a very good job at predicting pre-cancerous polyps.”

For the all of the at-home tests, Dr. Reickert recommends closely following the dietary restrictions, and returning samples promptly to the lab for best results. If any of the at-home tests detect blood or cancerous cells, you'll need to undergo colonoscopy for diagnosis.

“If you opt for an at-home test, the most important thing to remember is to actually do it," says Dr. Reickert. "All too often, we prescribe an at-home test and only a few patients fill their prescription or remember to mail the sample to the lab."

Deciding if an at-home test is right for you

At-home tests are best for people with an average risk level for colon cancer--those who do not have a family or personal history of colon polyps or colon cancer.

The reason? At-home kits only test for cancer cells and blood in your stool, which may indicate cancer or large polyps. At-home tests will not tell you if you have pre-cancerous polyps or smaller polyps. Only colonoscopy can make that early diagnosis.

Plus, Dr. Reickert says, it’s possible to have large polyps in your colon and not have blood in your stool, even microscopic amounts.

At-home tests might also be a good option for average-risk patients who have an alternative medical condition, gastrointestinal issues or limited mobility that may make it difficult to undergo sedation or the test prep that's required for colonoscopy. 

“While we don’t think at-home tests reduce your risk as much as colonoscopy, it’s still absolutely okay to do them," says Dr. Reickert. "No matter what method you choose, the best thing you can do is get screened."

If given the choice, however, Dr. Reickert strongly advocates for colonoscopy as the best means to catch pre-cancerous polyps and diagnose colon cancer at its earliest stage, when it’s treatable and curable.

“I understand many patients are nervous about colonoscopy, the prep and the procedure,” says Dr. Reickert. “I tell those patients that there are so many people who get through colonoscopy comfortably and quickly. At the end of the day, it’s a minor inconvenience with durable, lasting benefits.”

If you’re still not sure what’s right for you, Dr. Reickert says to talk with your physician. Together, you can make the best decision based on your risk, medical conditions and insurance coverage.

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At the Henry Ford Cancer Institute, our cancer screening specialist will work with your doctor to see which colon cancer screening option is best for you. We offer the full range of colorectal cancer screening tests, from colonoscopy to at-home FIT kits. For more information, visit henryford.com/services/colon-rectal-cancer/colorectal-cancer-screening or call 877-672-7336.

Dr. Craig Reickert is the Division Head of Colon and Rectal Surgery at Henry Ford Hospital. He also sees patients at Henry Ford Medical Center – Pierson in Grosse Pointe Farms.

Categories: FeelWell