• Drjohn

Types of colon screening

Updated: Sep 13, 2020

Let's talk the different types of screening:

Test options for colorectal cancer screening

Several test options are available for colorectal cancer screening:

Stool-based tests

  • Highly sensitive fecal immunochemical test (FIT) every year

  • Highly sensitive guaiac-based fecal occult blood test (gFOBT) every year

  • Multi-targeted stool DNA test (mt-sDNA) every 3 years

Visual (structural) exams of the colon and rectum

  • Colonoscopy every 10 years

  • CT colonography (virtual colonoscopy) every 5 years

  • Flexible sigmoidoscopy (FSIG) every 5-10 years (with a FIT test yearly).

There are differences between these tests that you should consider, but the most important thing is to get screened, no matter which test you choose. Talk to your primary care provider or to me about which tests might be good options for you, and to your insurance provider about your coverage.

This point is VERY important: If a person chooses to be screened with a test other than colonoscopy, any abnormal test result should be followed up with a timely colonoscopy.

Please be mindful that people at increased or high risk of colorectal cancer might need to start colorectal cancer screening before age 45, be screened more often, and/or get specific tests. This includes people with:

  • A strong family history of colorectal cancer or certain types of polyps (see Colorectal Cancer Risk Factors)

  • A personal history of colorectal cancer or certain types of polyps

  • A personal history of inflammatory bowel disease (ulcerative colitis or Crohn’s disease)

  • A known family history of a hereditary colorectal cancer syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome (also known as hereditary non-polyposis colon cancer or HNPCC)

  • A personal history of radiation to the abdomen (belly) or pelvic area to treat a prior cancer

To my knowledge the American Cancer Society does not have screening guidelines specifically for people at increased or high risk of colorectal cancer. However, some other professional medical organizations, such as the US Multi-Society Task Force on Colorectal Cancer (USMSTF), do put out such guidelines. Your particular situation, if you are an increased or high risk patient, is best discussed with your primary care physician or with me in light of your history, age, medications, co-morbidities.

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