Health Matters: Colon cancer screening — understanding your options

gilbert and patient

March 11, 2021

As COVID-19 impacted the world, unfortunately, we watched colorectal cancer screening rates drastically decrease at the local and national levels. Reduced screening rates were caused, in part, by the reduced availability of services briefly in the spring of 2020. But sadly, even as care became available again, the rates have remained lower than usual. This Colorectal Cancer Awareness Month, we're calling on everyone to help get screenings back on track.  

Regular screening is key to preventing colorectal cancer. If you're 50 to 75 years old, we recommend that you get screened for colorectal cancer regularly through one of the following options:    

FIT- Fecal Occult Blood Test

This at-home test helps detect occult blood (blood not seen with the naked eye) in the stool, which may indicate colon cancer.   

Where is it performed? You collect a stool at home and mail the test collection kit to a designated lab.  

How often is it needed? Every year.  

Is there any test preparation? Sometimes. Everyone needs to check with their doctor because these tests may require limiting certain foods and medications ahead of time.  

Other FIT test considerations? Since this test looks for occult blood, if the test result is positive, you'll still need a colonoscopy to find the bleeding source. It's important to remember that other conditions can cause blood in the stool, so this isn't always a reliable detection method for colorectal cancer.   

Stool DNA Test (Cologuard)

This at-home test helps detect altered DNA in the stool that passed through the colon. Stool DNA uses molecular markers to identify precancerous growths (polyps) and colon cancer.  

Where is it performed? You collect a stool at home and mail the test collection kit to the designated lab.  

How often is it needed? Every three years, with a normal result.  

Is there any test preparation? No. You don't have to prepare ahead of time for a Cologuard test.   

Other Stool DNA test considerations? Like the FIT Test, positive test results require a colonoscopy to find the abnormal cells' source. Providers will typically only recommend the Stool DNA test if you have average risk and you are over 50 years old.    


This is the gold standard test option. This procedure allows your doctor to look inside the entire colon to check for cancer or precancerous growths (polyps) with a thin, flexible tube with a camera attached. 

Where is it performed? Your doctor will administer the test within an outpatient procedure setting. You can go home shortly after the procedure.  

How often is it needed? Every 10 years, with a normal result.  

Is there any test preparation? Yes. Colonoscopies require complete cleansing of the colon using a clear liquid diet and a special solution to empty your colon. Most people consider the preparation process to be unpleasant, but it is short-lived and worth it if cancer is detected early or prevented entirely!  

Other colonoscopy considerations? This procedure requires sedation (you won't remember it). Unlike FIT tests or Stool DNA tests, colonoscopies allow your doctor to identify and remove growths, even at the precancerous stage.


Knowing your risk level is essential. Your risk level may impact what screening option your provider recommends. If you have an increased risk of colon cancer, your doctor might recommend more frequent colon cancer screening done by colonoscopy. These risk factors may include:   

  • Have a personal history of colon cancer or precancerous polyps  
  • Have a parent, sibling, or child who has had colon cancer  
  • History of inflammatory bowel disease  

While screening is one of the most critical aspects of colorectal cancer prevention, there are also other ways you can reduce your risk:    

  1. Eat lots of vegetables, fruits and whole grains. Diets that include lots of vegetables, fruits and whole grains can decrease the risk of colorectal cancer.  
  2. Get regular exercise. Being more active may help reduce your risk as high as 50%.  
  3. Don't smoke. Long-term smokers are more likely than non-smokers to develop colorectal cancer.  
  4. Limit alcohol consumption. Alcohol use is linked to a higher risk of colorectal cancer. 

While changing lifestyle habits may be challenging, even small steps can help lower your risks. The most important things to do to prevent colon cancer if you're under 50 are learning about your family history of colon cancer, living a healthy lifestyle, and alerting your doctor to any concerning changes to your health. If you're over 50, you can add colorectal cancer screening to the list because it is one of the most effective ways to prevent this common, sometimes deadly, common cancer. 

Dr. Andrew Gilbert is a primary care provider at St. Peter’s Health and he completes colonoscopies at the Regional Medical Center (hospital).