Alternative screenings to colonoscopies are better than no test at all
Doctors widely consider colonoscopies as the gold standard for detecting colon cancer, a disease that takes the lives of roughly 53,000 people each year.
That’s because colonoscopies are both “diagnostic and therapeutic,” says Ryan Busch, DO, a gastroenterologist with Bon Secours St. Francis Gastroenterology. “During a colonoscopy, your physician can see the lining of the colon and remove any precancerous polyps that you might have.”
Current guidelines suggest getting your first colonoscopy at age 45 and every 10 years after that if you have an average colon cancer risk and have a normal colonoscopy. If you have a family history of colon cancer, you need a colonoscopy starting at an earlier age and every five years onward.
Bon Secours St. Francis Gastroenterology will soon be the first facility in the Upstate to use GI Genius. Added to the computers used during colonoscopies, the AI tool helps increase detection rates of precancerous polyps. “It’s basically another set of eyes to help increase polyp detection rates, which reduce the risk of colon cancer,” Busch says. “It will really benefit patient care.”
Most insurers cover the cost of colonoscopies, but this procedure has a reputation for being unpleasant: You must follow a liquid diet and undergo a bowel prep beforehand. There’s also the prospect of missing work or other commitments for the sedation-required outpatient procedure. You could also have concerns about post-procedure discomfort like gas, cramping, or bleeding.
If any of those are deterrents to scheduling a colonoscopy, or if you have co-morbidities that make sedation risky, there are alternative screening tests. They are best for people who have an average risk of colon cancer.
There are two types of stool tests that your primary care provider can order, and both rely on lab clinics to analyze stool samples collected at home. A low-cost fecal immunochemical test (FIT) looks “for microscopic blood in the
stool,” Busch says, which could be a sign of colon cancer. The more expensive Cologuard test screens for both blood and polyp or cancer DNA.
You will need a colonoscopy if either test has abnormal results, and because both provide lower polyp detection rates, doctors recommend getting these tests more frequently “so you increase your chance of catching something, as early detection can save lives,” Busch says. FIT testing should happen annually; Cologuard tests should occur every three years.
Two other alternative tests come with bowel prep and follow-up colonoscopies if there are abnormal findings. Flexible sigmoidoscopies, which look at the left side of the colon, require an enema. They need to be repeated every five years and can be used in combination with FIT screenings, Busch says.
Virtual colonoscopies call for a full bowel prep and repetition every five years. In this screening, computerized software generates three-dimensional images from CT scans. Radiologists will look at these images, checking for polyps or other abnormalities.
“I think people should have a colonoscopy,” Busch says. “If they don’t want to do that, I like FIT testing or Cologuard. If you’re not going to do anything, these stool-based tests can help identify early problems and reduce rates of colon cancer.”
Bon Secours St. Francis Gastroenterology has a team of doctors ready to help determine the right colon cancer screening for you. For more information or to find a doctor, visit Bon Secours St. Francis Gastroenterology.
