There are several screening options available.

While some are non-invasive, colonoscopy remains the most effective screening test because it can both detect and remove precancerous polyps in the same procedure.

Your provider can help you choose the option that is right for you.

Let's take a look at four testing options:

1. Colonoscopy
2. Flexible Sigmoidoscopy
3. Stool DNA Test
4. FIT Test (Fecal Immunochemical Test)

Colonoscopy (Gold Standard)

A colonoscopy is considered the gold standard for colon cancer screening.

During the procedure, a gastroenterologist uses a thin, flexible camera to examine the entire colon. If polyps (small growths that can turn into cancer) are found, they can be removed immediately during the same procedure.

Why colonoscopy is the most effective screening option:

• Examines the entire colon
• Detects cancer and precancerous polyps
• Polyps can be removed during the procedure
• Only needed every 10 years for most average-risk patients
• Prevents cancer, not just detects it
• Because it both finds and removes precancerous polyps, colonoscopy is the most powerful tool we have to prevent colorectal cancer.

Flexible Sigmoidoscopy

A flexible sigmoidoscopy is a screening procedure that allows a provider to examine the lower portion of the colon (rectum and sigmoid colon) using a thin, flexible camera.

Because it only evaluates part of the colon, it can detect polyps or cancer in the lower third of the colon, but it does not examine the entire colon.

Things to know:

• Examines the lower part of the colon only
• Typically recommended every 5 years
• Usually requires less preparation than a colonoscopy
• Often done without sedation
• Polyps found may still require a follow-up colonoscopy
• Because flexible sigmoidoscopy does not evaluate the entire colon, cancers or polyps in the upper portions of the colon may be missed.

Stool DNA Test (Cologuard®)

A stool DNA test (commonly known as Cologuard®) is a non-invasive screening test that looks for DNA markers and blood in the stool that may indicate cancer or advanced polyps. The test is completed at home and mailed to a lab for analysis.

Things to know:

• Done at home
• Recommended every 3 years if results are normal
• Looks for DNA changes linked to colorectal cancer
• If the test result is positive, a follow-up colonoscopy is required to determine the cause.

FIT Test (Fecal Immunochemical Test)

The FIT test checks for hidden blood in the stool, which can be a sign of colorectal cancer. This test is also completed at home and returned to a lab for analysis.

Things to know:

• Non-invasive at-home test
• Must be done every year
• Detects hidden blood in stool
• Less sensitive at detecting cancer and precancerous polyps
• Studies show FIT tests detect about 70–75% of colorectal cancers, which means cancers and polyps may still be missed.
• As with other stool-based tests, a positive FIT result requires a follow-up colonoscopy.