Fecal matters: An at-home alternative to a colonoscopy

December 13, 2017 | by Matthew Siegel, MD

Does just thinking about getting a colonoscopy make you nervous? You aren’t alone. One in three adults ages 50 to 75 years have not been tested for colorectal cancer, as recommended by the U.S. Preventive Services Task Force (USPSTF). A recent study found that 70 percent of Americans ignore recommendations for screening colonoscopies due to their fear of the test.

Fear no more! There are other, less invasive screening options available that can help look for cancer in some individuals who are wary of a colonoscopy — and it can all be done at home. This type of screening test is called a DNA stool test.

A DNA stool test is a non-invasive test that checks for colon and rectal cancer by looking for certain gene changes that are sometimes found in colon cancer cells. The only FDA approved test, called Cologuard, can find abnormalities in your stool that indicate cancer or polyps.

Here’s how it works: A Cologuard Collection Kit is shipped directly to your home for you to get the process started. You collect a single stool sample using the kit, then send it to their science lab via a prepaid UPS shipping or pick-up. The results of the test are then sent to your doctor, who will contact you to discuss the next steps.

Unlike a regular colonoscopy, there is no special diet or bowel preparation (no laxatives or enemas) required. However, if the Cologuard test does indicate cancer or pre-cancer, you would then need a colonoscopy to confirm it and possibly remove any polyps.

Not everybody can have this type of screening test. A DNA stool test is only for people with a low-average risk of colon or rectal cancer, and no personal history of pre-cancerous polyps, colon or rectal cancer.

There are also other at-home screening tests that can be used to find polyps or cancer. These include:

  • The guaiac-based fecal occult blood test (gFOBT) which is done once a year and uses the chemical guaiac to detect blood in the stool. For this test, you receive a test kit from your healthcare provider and you use a stick or brush to obtain a small amount of stool at home.
  • The fecal immunochemical test (FIT) which uses antibodies to detect blood in the stool. It is also done once a year in the same way as a gFOBT.

There are some downsides to at-home stool tests compared to having a colonoscopy, such as how often they need to be done. Doctors recommend a colonoscopy once every 10 years, while these less invasive screening tests need to be done yearly.

Don’t let the fear of a colonoscopy stop you from getting screened and possibly detecting cancer early when it’s most treatable. There are strategies you can follow to ease your jitters. Technological advancements have also made the procedure much more comfortable.

The American Cancer Society recommends regular colon cancer screening for most people starting at age 50. If you have a family history of colorectal cancer or if you have any of these lifestyle-related risk factors, you should talk to your doctor about starting the screening process sooner.

Your doctor can help you determine the right screening test for you by discussing your family history, medical condition and personal preferences.

Are you at risk for colon cancer? Take the ColonAware Risk Assessment to find out.

Join us on Wednesday, March 7 at 7 p.m. at Edward-Elmhurst Health Center in Elmhurst, as gastroenterologist Michael Greenspan, M.D., provides the facts about colon cancer and the screening options available. An at-home screening test for colon cancer will be available to eligible participants ages 50-75. Registration is required. Register now.

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