Is there an alternative to getting a colonoscopy?

The idea of a colonoscopy may make some people want to run for the hills. It’s considered the gold standard for screening for colorectal cancer, but it presents some challenges for people who don’t have access to this type of testing or can’t tolerate the cost, bowel prep or anesthesia.

For those who fall in the latter category, results from a study published in the Annals of Internal Medicine offer some hope and encouragement: An affordable test can be taken annually at home to pre-screen for precancerous polyps or colorectal cancer.

For the study, researchers looked at data from 31 tests involving 120,255 individuals to see if fecal immunochemical testing (FIT) was effective at screening for colorectal cancer. In these studies, participants were asked to complete FIT testing, which involves collecting small stool samples at home. While the samples from the FIT tests were analyzed, the participants underwent a screening colonoscopy to detect signs of colorectal cancer.

Researchers found that in those studies, FIT results matched colonoscopy findings of precancerous lesions 91% of the time.

“This study doesn’t change the fact that the gold standard is still colonoscopy, but what it does do is allow us to recognize and embrace other screening or testing options that are equally good at detection,” says Dr. Joaquin Estrada, a colorectal surgeon at Advocate Illinois Masonic Medical Center in Chicago. “The colonoscopy may be the best test when it’s performed, but there are so many barriers. This study shows FIT is an adequate alternative to screen for a disease that is almost completely preventable.”

FIT testing is also a good option to “pre-screen” for pre-cancerous polyps or colorectal cancer.

“A significant proportion of individuals who undergo a screening colonoscopy test negative. A FIT test can help patients test for colorectal cancer without needing to take time off work or being subjected to the cost or anesthesia,” he says. “A positive FIT test may reveal that a colonoscopy is needed eventually, but for the vast majority of people, it may actually help avoid unnecessary screening.”

“At the end of the day, the best test is a completed test,” Dr. Estrada says. “The colonoscopy is still the gold standard, but for some patients for whom this type of screening isn’t a great option, FIT is a safe alternative.”

Want to learn more about your risk for colorectal cancer? Take a free, quick online risk assessment by clicking here.