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 colorectal surgeon Craig Reickert, M.D.

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

Patients now have three options available 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, patients swab their stool on card provided by their physician over the course of several days and mail it into the lab.“If you do fecal occult blood test or FIT every year, they are 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, patients collect their stool in a kit provided by their physician and ship it to the lab. If 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, a patient will need to undergo colonoscopy for diagnosis.

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

Deciding if an at-home test is right for you

At-home tests are best for people with an average level of risk 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 the prep the day before or sedation process for colonoscopy difficult.

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

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. In all, it’s a minor inconvenience with durable, lasting benefit.”

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.


To make an appointment for your colonoscopy or to talk with your doctor about your risk, visit henryford.com or call 1-800-HENRYFORD (436-7936).

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

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