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4 Ways to Screen for Colon Cancer Without a Colonscopy

May 14, 2024

If you’re dreading your next colonoscopy, you might be wondering about other options to screen for colon cancer.

But do they really work?

For answers, we turned to Ajay Ranade, MD, a general surgeon with Hartford HealthCare Digestive Health Institute.

Colonoscopies decrease your risk of dying from colon cancer.

Colonoscopies aren’t just important — they can save your life.

“Screening for colorectal cancer (CRC) directly leads to decreasing mortality rates,” answers Dr. Ranade. “In many instances, screening tools detect and remove polyps or lesions even before they become cancerous.”

Most healthcare societies and groups in the US start screening at age 45.

“This is the balance between patient harm, disease detection and prevention,” explains Dr. Ranade. “But screenings can start earlier based on individual signs or symptoms a patient may have. Family history also plays into the decision process for colonoscopy timing.”

> Related: Are These 5 Myths Keeping You From a Colonoscopy?

4 colonoscopy alternatives.

If you’re really averse to a colonoscopy, you’re not alone. And there are other options available, but only if your doctor thinks its appropriate.

“For patients with average risk, alternatives to colonoscopy may be reasonable,” says Dr. Ranade. “This answer comes from a discussion with your healthcare provider.”

Here are four of the most common alternatives to colonoscopy.

1. Fecal immunochemical test (FIT): “This test takes a small sample of a patient’s stool to evaluate the presence of blood. The presence of blood makes us more concerned about an underlying lesion but gives no additional information about whether it is cancerous or not.”
2. Flexible sigmoidoscopy: A flexible tube with a camera examines the rectum and the lower part of the colon. “This modality gives a direct visualization of the colon, but it is limited anatomically to the distal part of the colon, so it’s not as complete a view as a colonoscopy,” adds Dr. Ranade.
3. CT colonography: A CT scan visualizes your rectum and entire colon. “Patients like this option because of the lower risks of perforation as compared to colonoscopy. People still must take a prep and if there is anything inconclusive, the recommendation is colonoscopy,” he says.
4. Cologuard: “This test takes a small sample of a patient’s stool and evaluates for the presence of certain DNA mutations typically shed by colorectal cancers. No prep is required, so it’s convenient for the patient,” says Dr. Ranade. While this test is 92% sensitive for colon cancer, it’s much less sensitive when it comes to colon polyps. It can miss these precancerous lesions.

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But nothing beats a colonoscopy for a complete picture.

While alternative screening methods may be acceptable in average or low-risk populations, there are a few considerations Dr. Ranade wants you to know:

• If those screenings are inconclusive, your provider will likely recommend a colonoscopy.
• The current best option to evaluate the colon is a colonoscopy.
• Colonoscopies can also help diagnose other pathologies other than polyps and cancers.

“Colonoscopy provides the only live view of the colon performed by a trained eye,” says Dr. Ranade. “It can be therapeutic and diagnostic to limit cancer’s future progression and evolution.”

Still confused? Talk to your doctor.

Whether you need a colonoscopy or want to discuss other options, talk to your healthcare team.

“The best screening test is the one you will complete,” says Dr. Ranade. “Screenings gather essential information and evidence to help us better care for you.”