Colorectal cancer screenings are essential, even for those who feel healthy, as they can detect cancer and precancerous polyps in their earliest stages.
There are several types of colorectal cancer screening tests available, including visual, blood-based, and stool-based tests. While each type has its pros and cons, colonoscopy remains the best tool for detecting colorectal cancers.
Visual tests include colonoscopy, CT colonography, and sigmoidoscopy, which allow doctors to examine the entire colon for abnormalities. Blood-based tests like Epi proColon and Shield can screen stool for signs of cancer or polyps without requiring bowel prep. Stool-based tests, such as fecal immunochemical test (FIT), guaiac-based fecal occult blood test (gFOBT) and stool DNA test, look for hidden blood in the stool.
Colonoscopy is considered a gold standard for detecting colorectal cancers due to its ability to examine the entire colon. However, it also has cons such as requiring full bowel prep, sedation, and small risks of infection and bleeding.
“Multitarget stool DNA test (Cologuard) has a sensitivity of 92% in detecting colorectal cancer,” says Dr. Jessica Sang, a gastroenterologist at Atrium Health. “However, the sensitivity of the test for detecting advanced precancerous lesions is only 43%, which is why I recommend colonoscopy as the primary screening method.”
Colorectal cancer screenings are recommended based on personal risk factors, and individuals with average risk should begin regular screenings at age 45. Those who are high-risk may need to start screenings before age 45.
Ultimately, while colorectal cancer screenings may seem daunting, they are actually life-saving measures that can detect cancer in its earliest stages.
Source: https://atriumhealth.org/dailydose/2025/02/25/beyond-a-colonoscopy-less-invasive-colorectal-cancer-screening-options