Colonoscopy may be the most-hated medical screening.
The prep is miserable. You have to fast the day before. Then you have to take a laxative. This means hours of stomach cramps…and multiple trips to the bathroom.
And the procedure itself is no picnic, either.
It requires general anesthesia and a day of downtime. There is risk of bowel perforation. This is rare, but it can be life-threatening.
Doctors generally recommend that patients get colonoscopies starting at age 50, and then every five to 10 years after that.
But many people ignore this advice because they dread the procedure. One survey found that when doctors tell their patients to get a colonoscopy, only 38% do it.
During the pandemic, people may be even more reluctant to go into a clinic for the screening.
But now, a new study may mean they don’t have to.
The Easier, Accurate Alternative to the Dreaded Colonoscopy
Researchers found that an at-home test called FIT is just as accurate as a colonoscopy in detecting colon cancer.
FIT stands for fecal immunochemical test. It comes in the form of a kit that contains equipment and instructions for taking a stool sample and mailing it to a lab. A week or so later, you get an email with the results.
About 5%-6% of patients will have a positive test. They will need to undergo a follow-up colonoscopy. But the other 95% or so are done with colon cancer screening for the year…no uncomfortable prep, no need to skip work for a day, no colonoscopy.
You may have heard of another at-home colon cancer test called Cologuard. It’s used only every three years. But researchers have found it is less accurate than FIT or colonoscopies.
How does FIT stack up against colonoscopy?
For people with a history of colon cancer or polyps, colonoscopy still offers one distinct advantage: Polyps can be removed immediately.
But for people with normal risk, FIT has been found to be just as reliable in finding colon cancer.
Another upside: FIT is far less expensive, especially if you are paying out of pocket. It costs as little as $20. A colonoscopy runs more than $1,000.
So why do so many people still go through the ordeal of having a colonoscopy?
It’s because colonoscopies are a cash cow for many gastroenterologists, said Dr. James Goodwin of the University of Texas Medical Branch. “There’s a large financial incentive for people who do colonoscopies to do colonoscopies,” he said. So patients may not hear about alternatives.
The convenience of FIT means more people might get screened. Colon cancer is the third most common cancer in both men and women. About 50,000 Americans die from it every year. But if it is caught early, the cure rate is more than 90%. 
Dr. Deborah Fisher is an associate professor of medicine at Duke University. She says, “When it comes to colorectal cancer, the best test is the one you actually use.”
The next time you are due for a colonoscopy, ask whether you can use FIT instead.
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