Colonoscopy or home test: which is right for you?

In recent years, new products have hit the medical market as alternatives to having a colonoscopy. These alternatives, typically a take-home sample test, have gained popularity due to their convenience and relative non-invasiveness. However, they are far from perfect and not recommended for everyone.

Gastroenterologist Dr. Kevin Liebovich of Advocate Condell Medical Center in Libertyville, Ill., helps explain the benefits and shortcomings of each procedure to help you decide which option is the best choice for you.

Colonoscopy

A colonoscopy is an outpatient procedure performed by a gastroenterologist. During the procedure, a thin, lighted tube with a camera on the end is inserted into the rectum while the patient is under general or local anesthesia. The doctors examines the entire rectum and colon for any abnormalities or signs of cancer. Special preparations such as dietary restrictions and a laxative cleanse are required in the days leading up to the procedure.

On one hand…

While colonoscopies are somewhat extensive procedures, they typically only need to be done every 10 years after age 40, unless a patient has a prior history of gastrointestinal issues or family history of colorectal cancer.

“Colonoscopy is the gold standard in colon cancer screening and prevention,” Dr. Liebovich says.

It is the most comprehensive strategy to identify colon cancer, and any precancerous polyps can be removed before they can become cancer. Colonoscopies are covered under most insurance plans as a screening option, making them comparable in out of pocket costs, versus less invasive testing options.

On the other hand…

The nature of a colonoscopy gives it the reputation of being uncomfortable. The procedure requires patients to check into outpatient surgery, and in most cases be placed under general anesthesia. Patients are also required to follow a specific diet in the days prior to the surgery, as well as complete a laxative cleanse.

Home Tests

A fecal immunochemical test (FIT) is a cancer screening option that individuals can complete in the privacy of their own home then mail in for testing. The test can be obtained at the the doctor’s office and requires the individual to provide a stool sample. The sample is then mailed to a testing center and screened for abnormalities that could indicate cancerous or precancerous cells in the colon, such as microscopic blood. Once the physician is contacted with the results, they provide them to the patient along with any other follow-up recommendations.

On one hand…

Unlike a colonoscopy, this option is non-invasive and requires no preparation or dietary restrictions. It is also less time-consuming and can be done from home, making it a convenient option for busy individuals. The test is about $500 and covered by most insurance plans.

“For patients who prefer a less invasive approach, the FIT test is a reasonable alternative,” Dr. Liebovich says.

On the other hand…

Because this test only screens for the presence of blood in stool, it cannot guarantee the presence or absence of cancerous or precancerous cells. This means that not only are false positives and negatives possible, but also that further action may be required.

“The test only assesses risk for cancer and polyps, it does not prevent cancer,” Dr. Liebovich says.

Finally, because of the generalized nature of the FIT test compared to a colonoscopy, it must be completed every one to three years, versus every 10.

What’s the verdict?

Dr. Liebovich cautions that choosing this test over a colonoscopy may not be in individuals’ best interests.

“Colonoscopy is the only test to prevent colon cancer, because it is the most accurate test for diagnosing early cancer and removing polyps,” Dr. Liebovich says.

While the experience of a colonoscopy may not be desirable for some, Dr. Liebovich assures that the long-term benefit of catching or avoiding colon cancer is far worth the temporary discomfort or embarrassment.