When it comes to colorectal cancer, getting screened saves lives. Yet about one out of every three adults ages 50 to 75 are not up to date with their colorectal cancer screening, according to the American Cancer Society’s National Colorectal Cancer Roundtable.
In an effort to increase screening numbers across the country, some health insurers are mailing at-home colorectal cancer screening kits (typically stool DNA kits under the brand name Cologuard®) to people who are due for screening. If you get a screening kit in the mail, here are some questions to ask before you decide to use it.
Who is a good candidate for a stool DNA test?
People who have an average risk of colorectal cancer are eligible for a stool DNA test. It is not recommended for people who are at higher risk because of a history of polyps or a family history of colorectal cancer. People who are having any symptoms (like rectal bleeding, change in bowel habits, or abdominal pain) are also not candidates for a stool DNA test. People who have a history of inflammatory bowel disease, like Crohn’s disease or ulcerative colitis are not eligible; they need a colonoscopy. People who are unable or unwilling to get a colonoscopy may choose to consider a noninvasive, at-home screening test like this.
How does a stool DNA test compare to colonoscopy?
“Colonoscopy is one of the few tests that we have that can actually prevent colon cancer! If caught early, colon cancer is highly treatable. Screening can find cancer before you even have symptoms,” says Capital Digestive Care lead advanced practice provider Amy L. Stewart, CRNP.
A colonoscopy is the gold standard for colorectal cancer detection – it is the only test that can both screen (find cancer) and prevent (remove polyps before cancer has a chance to form) colorectal cancer. A stool DNA test is only used to detect potential cancer, according to the American Cancer Society. A stool DNA test can also return false positive results (suggesting potential cancer where there is none) or, more worryingly, false negative results (missing existing cancer). It must also be done more regularly (every three years rather than every 10 years).
What happens if my at-home test comes back with suspicious results?
If your stool DNA test results find something suspicious, the next step is a colonoscopy to see what is going on. In effect, patients in this situation will be paying for colorectal cancer screening twice – once for the at-home test, and again for the colonoscopy procedure. Patients who require follow-up colonoscopies may also face higher charges from insurers for the colonoscopy, since a follow-up procedure may not be covered at the same rate as the initial screening.
How do I decide which test to use?
Although colonoscopy is more effective than a stool DNA test, the best screening test is the one a patient actually takes. Capital Digestive Care offers a variety of screening tests, and our providers are happy to talk with patients to help them decide which method is best for them.
“While the prep for a colonoscopy isn’t fun, there are more options than in the past to make this more tolerable,” says Stewart. “Plus, you’re in your own home, your pajamas, and in your own bathroom while doing the prep – the most uncomfortable part. The actual procedure is a breeze – 20 minutes, and you’re asleep. Patients often tell me the prep isn’t as bad as people have made it out to be. Colonoscopy can not only detect colorectal cancer – but can actually prevent it by finding and removing polyps.”
Unsure if you should be screened for colorectal cancer? Fill out our online screening assessment tool.