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Colonoscopy vs. FIT vs. Cologuard

Colonoscopy vs. FIT vs. Cologuard

Colon cancer is one of the most common and preventable types of cancer in the United States, and screening is essential for preventing and reducing the risk of developing the disease. Yet, it is often neglected.

The benefits of colon cancer screening are clear: screening can detect pre-cancerous polyps and other abnormalities before they turn into cancer, drastically reducing the risk of colon cancer and improving survival rates for those diagnosed with it. Early detection is the key to successful treatment and recovery.

Which Screening Test Is Right For Me – Colonoscopy vs. FIT vs. Cologuard?

The best colon cancer screening test for you depends on your age, family history, and other risk factors. Currently, the gold-standard screening test is colonoscopy. Stool-based tests such as the fecal immunochemical test (FIT) and Cologuard are also available for screening. These tests often appeal to people because they are easy, but they come with several limitations.

Talking with your doctor to determine which screening test is right for you is important.
Below is information that outlines the differences between colonoscopy vs. FIT vs. Cologuard.

Screening Colonoscopy

Colonoscopy is a test to detect changes or abnormalities in the colon and rectum. During the procedure, a thin, flexible colonoscope is inserted into the rectum and slowly advanced through the entire colon. As the tube is inserted, the doctor can view the inside of the colon on a video monitor and look for any abnormal growths, inflammation, or bleeding. If abnormalities are found, a biopsy can be taken for further testing.

Pros

  • Provides a direct view of the entire colon and rectum
  • Allows for the detection and immediate removal of polyps
  • Allows for identification of cancerous tumors
  • Enables biopsies to be taken for further testing
  • Can be used to diagnose other conditions
  • Covered by most insurance plans

Cons

  • Requires sedation, which may not be advised for certain people
  • Requires bowel preparation
  • The procedure takes longer than FIT or Cologuard

FIT

FIT, or Fecal Immunochemical Test, is a non-invasive screening test used to detect hidden blood in the stool, which may indicate the presence of colorectal cancer or pre-cancerous polyps. FIT may be a useful part of colorectal cancer screening, especially in people that can not tolerate anesthesia.

If a FIT test indicates the presence of hidden blood, further tests such as a colonoscopy are necessary. A colonoscopy after a positive FIT test is often not covered by insurance, so you may have to pay more out-of-pocket. Because a FIT test is not as sensitive as other tests, there are more false-positives. That means you may have nothing present on a follow-up colonoscopy.

FIT tests are not very good at finding polyps. Finding and removing polyps is the key to preventing colon cancer.

Pros

  • Non-invasive and does not require sedation
  • Can be done home

Cons

  • Does not provide a direct view of the colon and rectum
  • Polyps or other abnormalities can be missed
  • False positives frequently occur
  • Follow-up colonoscopy after a positive test may not be covered by insurance

Cologuard

Cologuard is a non-invasive screening test used to detect colorectal cancer. This test uses a combination of stool-based DNA and hemoglobin testing to detect abnormal cells that can indicate the presence of cancer. Cologuard is a convenient way to try to catch colorectal cancer early. It is especially beneficial for individuals unable or unwilling to undergo a colonoscopy.

Cologuard has one major drawback associated with it – the rate of false negatives. That means that a person could have a negative test result, but actually have colon cancer. In that situation, the person may not have their colon cancer diagnosed until it is much more advanced and far less treatable.

As with FIT tests, positive Cologuard tests require a follow-up colonoscopy to be performed, which may not be covered by insurance.

Pros

  • Non-invasive and does not require sedation
  • Can be done at home

Cons

  • Has a high false-negative rate, leaving colon cancer undiagnosed
  • Has a high false-positive rate
  • Does not provide a direct view of the colon and rectum
  • Polyps or other abnormalities can be missed
  • Follow-up colonoscopy after a positive test may not be covered by insurance

The Bottom Line on Colonoscopy vs. FIT vs. Cologuard

A screening colonoscopy is the best way to detect colon cancer early as well as prevent it completely. While stool tests may be the best option for certain individuals, the vast majority of people benefit the most from colonoscopies starting at 45 years of age. Your doctor can also discuss colonoscopy vs. FIT vs. Cologuard to help you decide which is right for you.

If you are 45 or older, don’t delay colon cancer screening any longer – schedule your colonoscopy today!

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