Gina B., 75, wanted to be a good patient and get a colonoscopy just as her favorite doctor recommended. But life kept getting in the way. Between caring for her grandkids and weekend travel plans, the retiree’s schedule was surprisingly busy. She had come close to crossing it off her to-do list once, but had to abandon the prep the night before her screening. “It was just a little too much for me that time,” she says. “Which was too bad, because I wanted to get it over with!”
Gina is right to be thinking about colon screening. Colon cancer is pretty common in the U.S.: It’s our third most diagnosed cancer, and the second leading cause of cancer death. Although colonoscopy is the best test, there are other screening methods that are also good and much more convenient. In fact, you don’t even need to leave home. If you’re due for a screening and it’s not a great time for a colonoscopy, a home kit might be the answer.
Why colon screening is important
More than half of people diagnosed with colon cancer have no symptoms. If you want to catch it early before the cancer has spread, you need to get screened. Early stage colon cancer is much easier to treat: No chemo or radiation is needed, and the survival rate is over 90%.
The lifetime risk of developing colon cancer is about 1 in 23. But your family history makes a difference. People with a first-degree relative (parent, sibling or child) with colon cancer are 2 to 3 times more likely to get it than people without any family history. That’s why doctors sometimes recommend screening for people in their 30s, or even 20s.
Gina doesn’t have a family history of colon cancer. However, most people who are diagnosed are over 60, so she wants to be extra careful.
Types of colon screening
There are two general techniques doctors can use to screen for colon cancer. The first is by directly examining the colon itself. In a colonoscopy, the doctor uses a scope (a long, lighted tube) inserted in the rectum. For accurate results, you must avoid solid foods the day before and drink a liquid laxative that cleans out your insides. If the doctor finds any unusual growths, called polyps, he’ll remove them. Removing polyps actually prevents them from developing into cancer, something that other screening methods don’t do.
Similar examinations include virtual colonoscopy, sigmoidoscopy and barium enema, which all require the same prep as for a colonoscopy. Your doctor will let you know if one of these alternatives is appropriate for you.
The second type of screening tests your stool (another word for poop) for small amounts of blood or changes in DNA (your genes). This is where home kits come in.
“Imagine if all health tests were as easy as dropping an envelope in the mail."
How home kits work
Imagine if all health tests were as easy as dropping an envelope in the mail. That’s all you need to do to provide your sample to the medical lab. Technicians there will complete the tests and send the results to your doctor.
The only downside is what you’re sending: a stool sample. We promise the anticipation is much worse than the reality. The home kit gives you all the supplies and detailed instructions you need. Here’s how it works:
- Attach the provided collection paper to the rim of your toilet bowl. The paper will catch your next bowel movement.
- Brush an enclosed swab against the stool. The worst part is now over.
- Drop the swab of your sample into a plastic specimen pouch.
- The sealed pouch goes into a pre-addressed, stamped envelope.
- Mail it to the lab. You’re done.
Types of home kits
There are several kinds of home kits available, which test for different things. Your doctor will decide which one’s the best for you. The main tests are:
- FIT. The fecal immunochemical test checks for invisible traces of blood in your stool.
- FOBT. A guaiac fecal occult blood test also checks for hidden blood (“occult” is medical-ese for hidden). Before the test, you’ll need to avoid red meat and citrus a for a few days, and avoid some medications (ibuprofen, naproxen and aspirin) for a week.
- Stool DNA. This test looks for blood and abnormal DNA.
If the lab finds blood or abnormal DNA, your doctor will talk to you about follow-up testing. Gina ended up taking a stool DNA test and is thrilled she doesn’t have to think about a colonscopy for another three years or more. “The home kit was even easier than I expected,” she says. “And my doctor told me I’m still his star patient.”
Any health screening can be a little nerve-racking. But once it’s over, you should feel a sense of relief. You’ve done the right thing for your health. And you’ve set a good example for loved ones who may be putting off important screenings like this.
How will you celebrate completing your colon screening?
About the author
Maureen Shelly is a health and science geek living in New York City.