Your Screening Options Explained

Every person is different, and there is no one-size-fits-all approach to screening. Below are the most common options, explained clearly and simply.

COLONOSCOPY (The Gold Standard):

  • Frequency: Every 10 years if normal and average risk.

  • Why it’s the gold standard: It both detects AND removes polyps in the same procedure.

  • Sedation: You are comfortably asleep. Most patients remember nothing.

  • Accuracy: Highest sensitivity for detecting cancer and precancerous polyps.

  • Benefit: If polyps are removed, you reduce your cancer risk instantly.

FIT TEST (Fecal Immunochemical Test):

  • Frequency: Every year.

  • How it works: Detects small amounts of blood in the stool.

  • Pros: Easy, at-home, painless, no prep.

  • Cons: Must be repeated annually; only detects blood—not polyps.

  • Important: A positive FIT ALWAYS requires a follow-up colonoscopy.

COLOGUARD:

  • Frequency: Every 3 years.

  • How it works: Looks for both blood and DNA changes in stool.

  • Pros: Simple, at-home, approved for average-risk patients.

  • Cons: Higher false-positive rate; cannot detect or remove polyps.

  • Accuracy: detects 43% large precancerous polyps and 95% cancer.

  • Important: A positive test REQUIRES colonoscopy.

    Some reason when you need to have a colonoscopy instead of a Cologuard:

    • any GI symptoms (weight loss, anemia, change in bowel habits, change in bowel habits, etc.)

    • prior positive stool test with FIT or Cologuard

    • Prior pelvic radiation

    • Any increased risk for colon cancer:

      • Family history of polyps, cancer or genetic syndromes

      • Personal history of precancerous polyps, cancer, IBD

CT COLONOGRAPHY (Virtual Colonoscopy):

  • Frequency: Every 5 years.

  • How it works: CT imaging creates a 3D picture of your colon.

  • Pros: Non-invasive alternative for some patients.

  • Cons: Requires the same prep as colonoscopy; cannot remove polyps.

  • Important: Abnormal findings require colonoscopy.

CHOOSING THE RIGHT TEST:

The best test is the one that gets done.

For most people, colonoscopy is preferred due to accuracy and prevention capability.

For those hesitant or unable to undergo colonoscopy, stool tests are an alternative.

Your physician can help guide the decision based on your medical history, comfort, and risk factors.