Understanding At-Home Colorectal Cancer Tests vs. In-Clinic Screenings
Colorectal cancer is one of the most common cancers, but it is also one of the most preventable and treatable when caught early. If you or a loved one is due for screening, you may be wondering whether an at-home test, such as Cologuard, is a good option or if you should schedule a traditional in-clinic screening, such as a colonoscopy.
The decision between an at-home colorectal cancer test and an in-clinic screening is personal and should always be made in consultation with your care team. Below, we will explore the key differences between these options to help you have an informed discussion with your doctor about what is best for you.
The Importance of Colorectal Cancer Screening
Colorectal cancer screenings are designed to detect cancer at its earliest stages, often before symptoms appear. Screening can also identify polyps—small growths in the colon that may become cancerous—so they can be removed before they pose a threat.
There are two main types of colorectal cancer screenings:
At-home stool-based tests, such as Cologuard and FIT tests
In-clinic procedures, such as colonoscopies and sigmoidoscopies
Both options have advantages and disadvantages, and the best choice depends on your medical history, risk factors, and personal comfort level.
At-Home Colorectal Cancer Tests
At-home tests, such as Cologuard and FIT (Fecal Immunochemical Test), work by analyzing a stool sample for signs of cancer or precancerous changes. The process is simple:
Your doctor orders the test.
A kit is mailed to your home.
You collect a stool sample following the provided instructions.
You mail the sample to a lab for analysis.
Results are sent to your doctor, who will discuss them with you.
Benefits of At-Home Tests
Convenience: No need to schedule an appointment, take time off work, or undergo preparation.
Non-Invasive: No sedation, fasting, or bowel cleansing is required.
Accessible: Ideal for individuals who may be unable to undergo a colonoscopy due to medical conditions or other limitations.
Limitations of At-Home Tests
Less Comprehensive: At-home tests detect signs of cancer but do not allow for polyp removal, meaning a follow-up colonoscopy is required if abnormalities are found.
Potential for False Positives or Negatives: While effective, these tests are not 100 percent accurate, and abnormal results must be confirmed with a colonoscopy.
Not Suitable for High-Risk Individuals: Those with a strong family history of colorectal cancer, previous polyps, or a genetic predisposition should consider a colonoscopy instead.
Colonoscopy: The Gold Standard for Screening
A colonoscopy is considered the most effective screening method for colorectal cancer because it allows doctors to visually examine the colon and remove polyps in real-time.
The day before the procedure, you will need to follow a bowel prep regimen.
The procedure is performed under sedation in a clinic or hospital.
A doctor inserts a thin, flexible tube with a camera into the colon to check for abnormalities.
If polyps or suspicious tissue are found, they can be removed during the same procedure.
Benefits of a Colonoscopy
Most Accurate Screening: A colonoscopy provides a direct look at the colon, making it the most reliable test for detecting colorectal cancer and polyps.
Polyp Removal in Real-Time: If polyps are found, they can be removed immediately, reducing the risk of developing cancer.
Longer Screening Interval: If results are normal, another screening may not be necessary for 10 years.
Limitations of a Colonoscopy
Requires Preparation: You must follow dietary restrictions and take laxatives the day before to cleanse your bowel.
Invasive Procedure: Some people feel anxious about sedation or the procedure itself.
Requires Time Off: The recovery period may require taking a day off work and arranging for transportation home.
Choosing the Right Screening for You
The best colorectal cancer screening method for you depends on several factors, including:
Personal and Family Medical History: If you have a family history of colorectal cancer or polyps, a colonoscopy may be the better choice.
Risk Level: High-risk individuals should prioritize in-clinic screenings, while those at average risk may discuss at-home options with their doctor.
Personal Comfort and Convenience: If you are hesitant about invasive procedures, an at-home test may be a good starting point.
It is essential to talk to your doctor about your options. While an at-home test may seem like the easier choice, it is not suitable for everyone. If an at-home test comes back positive, you will still need a colonoscopy for confirmation.
Talk to Your Care Team
Colorectal cancer is highly preventable with early detection. Whether you choose an at-home test or an in-clinic screening, the most important thing is that you get screened.
We urge you to discuss your options with your doctor before making a decision. Your care team can help you determine the best screening method based on your unique risk factors and medical history.
Disclaimer: This blog provides general information and should not be considered medical advice. Always consult with your healthcare provider to determine the best screening approach for your needs.
Taking the step to get screened is an important move toward protecting your health. Speak with your doctor today to determine the best option for you.
Written By: Carolyn Vandenbroek, MSDM
Reviewed By: Srilata Gundala, MD
