Talk to your doctor to see which type is right for you
Colorectal cancer is one of the leading causes of cancer death in Kentucky, but it shouldn’t be—it is largely a preventable disease, thanks to the variety of screenings available to the public:
Colonoscopy The most well-known screening method, colonoscopies are extremely effective at detecting colorectal cancer and precancerous lesions. During this test, doctors will examine the rectum and entire colon using a colonoscope, and they can actually remove any abnormal growths as they find them. This screening requires a complete cleansing (“prep”) of the colon using an oral laxative, and most patients will be under sedation throughout the procedure.
CT colonography Also known as a virtual colonoscopy, this is a CT scan of the entire colon and rectum. It requires bowel prep, but patients do not need sedation. It is less invasive than a colonoscopy, but is diagnostic only—if polyps are found, patients will need a traditional colonoscopy to remove them.
Sigmoidoscopy This is similar to a colonoscopy, but only looks at part of the colon. Most patients do not need sedation, and bowel prep is less extensive than a colonoscopy (two enemas only). If there is an abnormal finding, a full colonoscopy is required.
Fecal occult blood tests (known as gFOBT or FIT tests) This test looks for blood in the stool, which can be a sign of polyps or colorectal cancer. Patients collect their own stool samples using a kit and return the sample to their doctor. Depending on which type of test you are given, there may be dietary restrictions prior to testing.
Stool DNA test (Cologuard) In addition to checking for blood in the stool, this also checks for nine DNA biomarkers in genes that have been found in colorectal cancers. Patients collect their own samples using a kit and mail it to a laboratory for testing. This test is more accurate than a gFOBT or FIT test, but is also more likely to result in a false positive. All three at-home tests need to be repeated on a yearly basis, and any positive findings will require a follow-up colonoscopy.
Not all insurances cover every type of screening—speak with your doctor and insurance company to determine which test works best for you.
Dr. Avinash Bhakta is a colorectal surgeon at the University of Kentucky Markey Cancer Center.