At-home stool tests for colon cancer: Are they right for you?

As a primary care physician, nothing quite heralded my patients’ fifth decade of life as a discussion around getting their colonoscopy. Suddenly, their charts would light up with reminders to get their colonoscopies, with automated communications and electronic medical records prompting that discussion at every opportunity. And all that for a good reason: In 2020, colorectal cancer was the second leading cause of death in the United States. But despite the data and the longstanding screening guidelines, the CDC estimates that only 7 in 10 patients between the ages of 50 and 75 are caught up with their colon cancer screening. 

So why do so many of us choose to delay this lifesaving test?

There can be many reasons, but one that comes up frequently in my patient discussions is apprehension around undergoing a colonoscopy. During a colonoscopy, your doctor passes a probe with a camera through the anus and can look inside your colon. It allows your doctor to remove any suspicious lesion and send it to the lab for testing. For the doctor to see clearly, there needs to be no stools in the colon. That means an intense round of laxatives on the day before the procedure. This can be quite distressing to many patients. Furthermore, a colonoscopy requires the patient to take time off work and arrange transportation after the procedure when they feel drowsy from medications. All of this results in fewer patients who can or want to go through with a colonoscopy. 

Stool-based test alternatives

Fortunately, stool-based screening tests offer an excellent alternative to be done at home. There are several stool-based tests, including the Fecal Immunochemical Test (FIT) and other DNA-based tests. These tests look for chemical signals released by colon tumors. When results are normal, patients can go one to three years between screening depending on the test in question. Abnormal results let the patient know about the pressing need to get a follow-up colonoscopy. 

A FITest kit can be mailed to homes and samples conveniently sent back using return labels included in the kit. Patients do not need any sedation, time off work, or laxatives to complete a FIT test. Data does support that stool-based screening tests like FIT tests can reduce the chance of dying from colon cancer. However, how they directly compare to a colonoscopy depends on the individual test and would be best discussed with a healthcare provider.

In summary, stool-based colon cancer screening test kits offer a convenient and effective alternative to a traditional colonoscopy for many patients. You can order a FIT test kit through Primary.Health.