Colon cancer screening: Weighing the options

Colon cancer screening can be an important part of routine health care. If you’re not sure which colon cancer screening test is best for you, ask yourself these questions.

If your doctor has recommended colon cancer screening, you might be able to choose from various colon cancer screening tests.

If you’re reluctant to make a decision, remember that any discomfort or embarrassment from colon cancer screening is temporary — and detecting problems early could save your life.

Screening tests are used only if you don’t have bowel symptoms. If you have signs and symptoms — such as abdominal pain, a change in bowel habits, bleeding, constipation or diarrhea — then you’ll need other tests to address these problems.

If you don’t have bowel symptoms, consider the following questions to help choose the colon cancer screening test that’s best for you.

What preparation is involved?

Preparing for colon cancer screening can be uncomfortable or inconvenient, but it’s necessary for the test to be effective. As part of your decision, consider your willingness or ability to follow the preparation instructions for specific colon cancer screening tests.

This may — to varying degrees — include avoiding solid food the day before the exam, adjusting your medications, and using laxatives or enemas to empty your colon.

How convenient is the test?

In addition to test preparation, consider:

• How long the test will take
• How often you need to repeat the test
• Whether you’ll need sedation
• How much follow-up care you’ll need
• The possible need for follow-up testing to investigate a false-positive finding or to remove tissue

What about cost and insurance issues?

Find out how much each colon cancer screening test costs, as well as which tests your insurance company covers. Consider whether you’re willing to pay out of pocket if necessary.

What is your attitude toward screening tests?

The more thorough the colon cancer screening test, the more likely it is to detect any cancer or precancerous polyps. Conversely, a more thorough test might also mean more inconvenient or uncomfortable preparation, a slightly higher risk of serious complications, or both.

Ask yourself:

• Will you feel best if you know you’ve chosen the most thorough screening test possible?
• Will you worry or doubt the results if you choose a less thorough test?
• How concerned are you about convenience, preparation or the possibility of serious complications?

What is your doctor’s approach to screening tests?

Make sure that you’re comfortable with the colon cancer screening test your doctor recommends. If your doctor specializes in a particular test, but you’d rather have another test, express your wishes. Your doctor might offer a referral to someone trained in the test with which you feel most comfortable.

What is your risk level?

Your risk of colon cancer might influence your choice of screening tests. If you have an increased risk of colon cancer, your doctor might recommend more frequent colon cancer screening with colonoscopy.

Talk to your doctor about your colon cancer risk if you:

• Have a personal history of colon cancer or precancerous polyps
• Have a parent, sibling or child who has had colon cancer
• Carry a gene for a hereditary colon cancer syndrome
• Have a history of inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease