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Colonoscopy Remains Gold Standard For Colon Cancer Screening

The idea of undergoing a colonoscopy can make nearly anyone squirm. Yet despite other, less invasive options, colonoscopy remains the gold standard for colon cancer screening. 

Kenneth Reed, DO, explains why. “It’s a very good test because you cannot only prevent colon cancer, but also diagnose it. If someone has a polyp then you can find it, remove it, and help prevent the disease. Likewise, if we discover an early-stage cancer, then we can find it, mark it, and know exactly where it is at.” 

Alternative Screening Options

Other screening options leave room for error or, in some cases, may require a follow-up colonoscopy once something is found, Dr. Reed said. These options include:

• Fecal immunochemical test (FIT). Tests the stool for DNA or gene changes found in cancer cells. FIT has a 13 percent false positive rate and must be performed every one to three years. Positive results often require a follow-up colonoscopy.
• Fecal occult test. Checks for hidden blood in the stool, which can be an early sign of cancer. It should be performed every year and has a 15 percent false positive rate. It is generally not used to diagnose colon cancer. According to Dr. Reed, it is a very old test that has “fallen out of favor because it is not specific or sensitive enough to deliver the accurate results needed.”
• Cologuard. This new colon cancer screening test uses a person’s DNA, rather than blood, to indicate the presence of tumors. The test is approved by Food and Drug Administration (FDA), and is advertised as a colon cancer screening that’s as easy as “going to the bathroom.” However, Dr. Reed and others argue it is less accurate than colonoscopy.

“Most of these tests are finding colon cancer when it has already occurred,” Dr. Reed said. “Colonoscopies remain the only test that can help prevent colon cancer because we are able to find polyps that need to be removed before they become cancerous.”

Dr. Reed explains the various colon cancer screening methods but says that colonoscopy is the best option, the gold standard.

Click play to watch the video or read video transcript.

While Dr. Reed says that colonoscopy is the best test to screen for colon cancer, people of average colon cancer risk may elect one of the other options, after talking with their physician. 

“The guidelines are trying to get people to do whatever they can to be tested,” he explains. “The gold standard, again, is a colonoscopy. But if people aren't willing to do that, if there are some cost restraints, if there is something related to people's fear of the colonoscopy, of having sedation, then by all means, anything to get people to get tested would be preferable than nothing at all.”

Dr. Reed talks about choosing a method of colon cancer screening. 

Click play to watch the video or read video transcript.

Colon Cancer Risk Factors

If you have one or more of the following risk factors, check with your physician to determine if a screening other than colonoscopy is appropriate:

• Being older than 50
• African American race
• Previous colorectal cancer or polyps
• Inflammatory intestinal conditions
• Family history
• Low-fiber, high-fat diet
• Sedentary lifestyle
• Diabetes
• Obesity
• Smoking
• Heavy alcohol use
• Radiation therapy for other cancers

Dr. Reed offers advice on when to be screened for colon cancer.

Click play to watch the video or read video transcript.

Sources: Kenneth Reed, DO, Premier Gastroenterology Specialists