Ask most physicians which test is the best when screening for colon cancer and they’ll likely say, “The best screening test is the one that gets done.”
With recent advances in screening test development, that means that colonoscopy once every 10 years isn’t the only option. Newer FIT tests, short for fecal immunochemical test, or stool DNA tests offer patients options that can be more convenient and easier to complete.
“Colonoscopy is still the gold standard for colon cancer screening because it can prevent cancer by detecting pre-cancerous polyps and allow for removal before they turn to cancer,” said Dr. Clark Harrison, a gastroenterologist at Reno’s Gastroenterology Consultants and president of the Nevada Colon Cancer Partnership.
“The downside is that many people won’t have a colonoscopy because they’re concerned about discomfort or can’t take a day off work, while others have medical conditions that prevent them from getting this type of screening. But research shows that if patients are given the option of colonoscopy or one of the at-home stool tests they’re more likely to get screened regardless of which option they choose. For us, that’s a win.”
FIT tests, an alternative screening option, can be completed at home using a small sample of stool which is collected and then mailed to a laboratory for testing. The FIT test can detect small amounts of blood in the stool that could indicate cancer is present. If the result is positive a follow-up diagnostic colonoscopy may be required.
FIT tests are offered by many community health clinics, such as Community Health Alliance/HAWC clinics in Reno, as a low-cost yet effective alternative to colonoscopy. FIT tests can be purchased locally for $15 to $20 and should be completed annually.
The stool DNA test, Cologuard, was recently approved by the FDA and is also an at-home test that is mailed to a lab for testing. This test identifies altered DNA or blood in the stool, and like the FIT test can indicate if cancer is present. Cologuard is more expensive, costing about $600, must be prescribed by a doctor, and also requires annual testing.
Colon cancer is the second leading cause of cancer death for men and women in Nevada and nationwide, but with proper screening and early detection the risk of dying from colon cancer can be reduced by up to 70 percent. Colon cancer screening is recommended for average risk adults aged 50 to 75, or starting at 45 for African Americans. Those with a family history of colon cancer are advised to begin screening earlier and should talk with their physician about when to start.