What costs the same, has the same goal, but isn’t the same? Colon cancer remains one of the top cancers diagnosed in the U.S., but its mortality rate is declining largely due to screening. So, how do you know which type of screening is right for you? Understanding the pros and cons of colonoscopies and at-home tests will help you make the healthiest choice for your colon.

A Bit About Colon Cancer


Colon cancer happens in the large intestine, which is at the end of the digestive tract. It is the third most commonly diagnosed cancer and the third greatest cause of cancer-related death in the U.S. with approximately 95,500 new cases diagnosed each year. Colon cancer usually begins with small, abnormal tissue bumps, called polyps, in the intestinal wall. Polyps can become cancerous and are considered warning signs of potential future cancer. A difficult factor in diagnosing colon cancer is that symptoms do not regularly occur, and if they do occur, they frequently don’t appear until the cancer has reached a later stage. Incidence of death from colon cancer has seen a 50% decline due to the promotion of regular screenings.

Getting Tested


It is clear that regular screening is important in reducing the risk of death from colon cancer, but what kind of screening is the most helpful? In recent years, a number of home tests for colon cancer have become increasingly more visible on TV commercials and other advertisements. These tests’ primary benefits are comfort and convenience. They are usually non-invasive fecal tests that require no dietary preparation. Most insurance covers at-home screenings, it is important to understand that insurance covers one colon screening test. The prevalence of false positives in home testing is an important point, these false positives trigger a follow up colonoscopy. At-home tests are also less efficient at detecting the presence of pre-cancerous polyps. There are two types of home tests, one screens for the presence of blood the other screens for DNA of tumors, both are pretty good at detecting advanced cancers but are less successful at finding precancerous polyps and early stage cancers. The real advantage to a colonoscopy is the ability to find and remove precancerous polyps. Removing these polyps actually prevents colon cancer.

For years, doctors have recommended regular colonoscopies starting at age 50. Recently, the American Cancer Society lowered the age recommendation to 45. Insurance companies have not changed the age that triggers coverage, but if you are at high risk or nervous about the possibility of colon cancer you should see a Cary Gastro gastroenterologist. Colonoscopies can provide a great piece of mind. If there are no risks detected, a person only needs a colonoscopy every ten years. Like home tests, screening colonoscopies are covered by most insurance plans, with no out-of-pocket expense to the patients. If the patient uses their one time screening benefit on the home test, their insurance will not cover the follow up colonoscopy as a screening test and patients will be responsible for any deductibles and copays.

In the end, the pros of a colonoscopy far outweigh the purported convenience factors of at home tests . It is a more reliable screening, a more accurate determination of risks, and the only test able to help prevent cancer by removing polyps. For people with a history of cancer or inflammatory disease, an effective test like a colonoscopy is even more important. And again, if you do receive a positive on your home test, you need a colonoscopy to confirm anyway, and it can add undue worry in the meantime. Colon cancer is a serious enough condition to warrant the best screening available, and currently that is a colonoscopy. 

If you are due for a colon cancer screening and have additional questions about home tests, or if you would like to schedule your colonoscopy, Cary Gastro would love to help. You can request an appointment with us online for one of our locations.