Despite Options, Colonoscopy Remains Gold Standard for Colon Cancer Screening

Health Minute

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, with Premier Gastroenterology Specialists 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.”

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

For more information about colon cancer and colonoscopy, talk with your doctor or visit us online.