At-Home Colon Cancer Tests vs Colonoscopy: What's the Difference?

Here's an overview of screening tests so you can decide which is right for you.

Colorectal cancer often develops quietly, and many people have no warning signs until the disease is more advanced. That's what makes screening so important. When colorectal cancer is found early, treatment is often simpler and outcomes are better. Screening can also stop cancer before it starts by finding and removing precancerous growths.

There are multiple options available to screen for this type of cancer. Some tests can be done at home while others are done in a medical office. Each has its benefits, limitations and recommended uses. Understanding how the different types of testing compare can help you make an informed choice about what's best for you.

Types of Colorectal Cancer Screening

Colorectal cancer screening falls into two general categories. One group of tests looks for signs of cancer in stool. The other looks directly inside the colon.

• At-home stool tests – These check for hidden blood or abnormal DNA that may come from cancer or large polyps. The most common options include fecal immunochemical tests (FIT) and stool DNA tests. These tests are done at home and mailed to a lab for results.
• Colonoscopy – This is an in-office procedure where a doctor uses a small camera to examine the entire colon and rectum. If polyps or abnormal tissue are found, they can usually be removed during the procedure.

Who At-Home Tests Are Good For

At-home tests are generally recommended for adults at average risk for colorectal cancer. This usually means they have no personal history of colorectal cancer or polyps, no strong family history and no inflammatory bowel disease. Most experts recommend screening beginning at age 45 if you're at average risk. FIT tests are typically done every year. Stool DNA tests are usually done every three years if results are normal.

These tests are popular because they're easy to do in the privacy of your home. There's no bowel prep, no sedation, no big expense and no need to take time off work. But they can't prevent cancer. They only look for signs that cancer or advanced polyps may already be present. A positive result always needs follow-up with a colonoscopy.

Who Should Consider Colonoscopy

Colonoscopy is often recommended for people at higher risk for colorectal cancer and is typically repeated every 10 years if nothing abnormal is found. It's best for those with a family history of the disease, a personal history of polyps or certain genetic conditions. It's also the next step after an abnormal at-home test.

While preparation can be inconvenient, colonoscopy has a major advantage. It can find small polyps that may not be detected during at-home tests. It can also remove them on the spot, before they cause problems.

Choosing the Right Screening Option

Health organizations like the Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force agree that regular colorectal cancer screening saves lives. And many health experts suggest that the best test is the one that you're willing to do.

For some people, being able to do an at-home test means they're more likely to get screened. For others, colonoscopy offers reassurance and longer-lasting protection. Talking with a healthcare provider about your health history can help you decide which test is right for you.

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