Colonoscopy, Blood-Based, FIT, or Cologuard?

• This is considered the gold standard of colorectal screening. Recommended for average and higher risk patients.
• Pros: 95% accurate at detecting colorectal cancer. 1 step test, meaning polyp removal at time of exam; usually covered by insurance with no out-of-pocket.
• Cons: Prepping for exam, need to take a day off.
• Non-preventative options to detect colorectal cancer. Colonoscopy required if test results are positive.

• 73.8% accurate at detecting colorectal cancer.
• Pros: Easy to do, no change to diet or medication regimen.
• Cons: Does not detect all cancers or polyps, has to be completed every year.

• Pros: Can be completed at home.
• Cons: $500 out of pocket expense not covered by all insurances. Up to 45% false positive. Not recommended by American College of Physicians. Has to be completed every 3 years. If positive, colonoscopy needs to be completed.

• Endorsed by ACS for those unwilling/unable to do colonoscopy or stool-based testing.
• Pros: Easy to do, no change to diet or medication regimen.
• Cons: Does not detect all cancers or polyps, has to be completed every 3 years.

If you answer yes to the following, you are at a higher risk of having colorectal cancer and should have the gold standard colonoscopy.

• Personal history of colorectal cancer or certain types of colon polyps
• Family history of colorectal cancer? Start at Age 40 or 10 years before age of diagnosis
• Personal history of Inflammatory Bowel Disease (Ulcerative Colitis or Crohn’s disease)
• Symptoms such as persistent change in bowel habits or stool consistency, abdominal discomfort, rectal bleeding or blood in stool, unexplained weight loss, anemia, fatigue or weakness.
• A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colorectal cancer or HNPCC)
• A personal history of getting radiation to the abdomen (belly) or pelvic area to treat a prior cancer