Colorectal Cancer Screening

WHAT IT IS?

A medical procedure that allows a doctor to visually examine your entire colon and rectum to look for precancerous polyps. The patient is sedated and bowel prep is required. A colonoscopy is often considered the “gold standard” for colon screening because it can identify polyps and remove them during the same procedure. Visit our colonoscopy page for more in-depth information.

In order for a colonoscopy to be effective, you first have to prep. Learn about all of your prep options on our colonoscopy prep page.

HOW MUCH DOES IT COST?

Varies by insurance, however for those eligible for screening based on the USPSTF screening guidelines, screening tests must be covered with no cost sharing to the patient. If you’re considering skipping or postponing screening because you don’t have insurance or the funding, think again. There are ways to get a free or low-cost colonoscopy.

• CDC’s CRCCP program: If you’re age 45 and over, check the Center for Disease Control and Prevention’s Colorectal Cancer Control Program (CRCCP) to see if you’re eligible for free screening from a grantee near you.  You will need to contact the specific awardee directly to see what options are available.
• Colonoscopy Assist: A colon cancer screening program designed to remove financial barriers to colorectal cancer screening for the uninsured.
• Local Health Departments: Call your local health department and ask if there’s a state-funded colorectal cancer screening program near you.
• Primary Care Physician Referrals: Ask your PCP if they know of a gastroenterologist who provides services to underinsured or uninsured. During March, Colorectal Cancer Awareness Month, many health care providers offer reduced-cost or free colonoscopies.

WHEN SHOULD IT BE REPEATED?

Every 10 years, if normal.

WHERE IS IT PERFORMED?

Outpatient surgical center or hospital.

THINGS TO CONSIDER

Complications are rare but can include bleeding, infection, and bowel-wall injury. 

WHO IS A GOOD CANDIDATE?

Most people are good candidates. This test is among the best ways to find and remove polyps early.

WHAT IT IS?

Stool is collected at home and sent to a lab, which looks for small amounts of blood. You will be given instructions about how to use the kit at home, and where to send it when completed. One stool sample is needed. You will not have to touch the stool (but do a thorough hand-washing once you’ve collected the sample). There are no drug or dietary restrictions to take the test.

HOW MUCH DOES IT COST?

Screening tests must be covered by insurance. Coverage for a follow-up colonoscopy, if needed due to a positive test result, should also be covered by insurance.

WHEN SHOULD IT BE REPEATED?

Every year, if normal.

WHERE IS IT PERFORMED?

The patient’s home.

THINGS TO CONSIDER

It can’t detect or remove polyps. If you receive a positive test result, a follow-up colonoscopy is required.

WHO IS A GOOD CANDIDATE?

Great option for people hesitant to have a colonoscopy, but it must be performed every year.

WHAT IT IS?

Stool is collected at home and sent to a lab, which looks for small amounts of blood or DNA markers associated with colorectal cancer. You will be given instructions about how to use the stool DNA kit at home, and where to send it when completed. One stool sample is needed. You will not have to touch the stool (but do a thorough hand-washing once you’ve collected the sample).

HOW MUCH DOES IT COST?

Screening tests must be covered by insurance. Coverage for follow-up colonoscopy, if needed due to a positive test result, should also be covered by insurance.

WHEN SHOULD IT BE REPEATED?

Every three years, if normal.

WHERE IS IT PERFORMED?

The patient’s home.

THINGS TO CONSIDER

It can’t detect or remove polyps. If you receive a positive test result, a follow-up colonoscopy is required.

WHO IS A GOOD CANDIDATE?

Great option for people hesitant about a colonoscopy, but it must be performed every three years.

WHAT IT IS?

Stool is collected at home and sent to a lab, which looks for small amounts of blood. You will be given instructions about how to use the kit at home, which medications and foods to avoid (such as nonsteroidal anti-inflammatory drugs [NSAID] like ibuprofen and others) and where to send it when completed. Three stool samples are needed. You will not have to touch the stool (but do a thorough hand-washing once you’ve collected the sample). This test is no longer commonly used and has been mostly replaced by FIT.  

HOW MUCH DOES IT COST?

Generally inexpensive. You can purchase this test over the counter without a prescription.

WHEN SHOULD IT BE REPEATED?

Every year, if normal.

WHERE IS IT PERFORMED?

The patient’s home.

THINGS TO CONSIDER

It can’t detect or remove polyps. If you receive a positive test result, a follow-up colonoscopy is required. Requires restrictions on certain drugs and food prior to taking the test.

WHO IS A GOOD CANDIDATE?

Great option for people hesitant about a colonoscopy, but it must be performed every year.

WHAT IT IS?

A noninvasive, advanced CT scan of the colon and rectum that produces two- and three-dimensional images of the colon and rectum, allowing the doctor to look for polyps or cancer within the images. The entire colon must be cleaned out for this procedure, just like a traditional colonoscopy. If abnormalities are found, your doctor will talk to you about the appropriate diagnostic procedure moving forward. Not everyone is a candidate for CT colonography, so be sure to talk to your doctor about this screening option.

HOW MUCH DOES IT COST?

Should be covered by insurance, but you may want to discuss with your insurance provider before undergoing this screening exam.

WHEN SHOULD IT BE REPEATED?

Every five years.

WHERE IS IT PERFORMED?

Hospital, clinic, or outpatient imaging center.

THINGS TO CONSIDER

If any abnormalities are found, such as polyps, a follow-up colonoscopy is required. 

WHO IS A GOOD CANDIDATE?

People who aren’t eligible or cannot tolerate a traditional colonoscopy.

WHAT IT IS?

A doctor uses a tool called a sigmoidoscope to look at the sigmoid colon (the last section of the bowel) and the rectum, removing any visible polyps. This is different from a colonoscopy because a colonoscopy allows the doctor to see the entire large intestine. Because less than half of the large intestine and all of the rectum can be seen with this method, they are often done in combination with the gFOBT or FIT test, to test for blood in the stool. Prior to this procedure, an enema is done to clean out the lower part of the colon and the rectum.

HOW MUCH DOES IT COST?

Screening tests must be covered by insurance. If abnormal, coverage for follow up colonoscopy should also be covered by insurance.

WHEN SHOULD IT BE REPEATED?

If normal, every five years or in combination with FIT or gFOBT.

WHERE IS IT PERFORMED?

Outpatient surgical center or hospital.

THINGS TO CONSIDER

This test does not visualize the entire colon, so it is not as thorough as a traditional colonoscopy. 

WHO IS A GOOD CANDIDATE?

Most people are good candidates. Discuss this option with your physician to determine if it is appropriate for you. 

WHAT IT IS?

A capsule colonoscopy is a unique type of screening that involves swallowing a vitamin-size pill that contains a wireless camera. A capsule colonoscopy is different in that it is able to image the entire digestive tract — from mouth to rectum. This includes imaging areas that are not normally seen by a traditional colonoscopy, such as the small intestine.

HOW MUCH DOES IT COST?

Varies by insurance, but screening tests must typically be covered.

WHEN SHOULD IT BE REPEATED?

If normal, every five years.

WHERE IS IT PERFORMED?

The capsule will be given to you at your physician’s office. After swallowing it, you are free to go home. You will either need to return to your physician’s office to return the external recording equipment, or you may need to retrieve the capsule from your stool and return it, depending on which specific capsule you were given.

THINGS TO CONSIDER

This is generally a low-risk screening option, but there is a possibility that the capsule can become stuck and must be retrieved surgically. If polyps or abnormalities are found, a follow-up colonoscopy is required.

WHO IS A GOOD CANDIDATE?

A capsule colonoscopy is typically only an option for individuals who cannot or will not tolerate a traditional colonoscopy. Discuss this option with your physician if you are interested. 

WHAT IT IS?

There are currently no FDA approved blood-based screening tests – however, the research is accelerating quickly and options are rapidly emerging. There are two different types of blood-based screening tests for cancer: Single-Organ screening tests and Multi-Cancer Early Detection (MCED) screening tests. So, what’s the difference?

Single-Organ Blood Screening Test:

• These look for only one type of cancer.
• A yearly sample needs to be taken.
• If you receive a positive result, a follow-up colonoscopy is required.

Multi-Cancer Early Detection (MCED) Screening Tests:

• Some can detect more than 50 types of cancers in one test.
• These are designed to focus on tumors that are more aggressive.
• They are used alongside Single-Organ tests for more accurate results.

THINGS TO CONSIDER

There are currently no FDA-approved blood-based screening tests; however, the research is accelerating quickly and soon there may be more options. Manufacturers are working to ensure coverage of additional screening tests as they are approved by the FDA, but it is best to call your insurance provider to determine screening tests that are and are not covered.