What to Know About At-Home Colorectal Cancer Tests
James Grant, M.D.
| 3 min read
James D. Grant, M.D., is executive vice president an...
Key Takeaways
- The U.S. Preventive Services Task Force recommends average‑risk adults begin colorectal cancer screening at age 45.
- At‑home stool‑based tests are convenient but must be done annually, are less accurate than colonoscopy and any abnormal result should be followed up with a colonoscopy.
- Patients with symptoms, a family history of colon cancer or other risk factors should discuss colonoscopy as the preferred screening method with their primary care provider.
Colorectal cancer continues to be one of the most common cancers in the United States, with an estimated 158,850 new cases predicted in 2026, according to the American Cancer Society.
One of the best defenses against colorectal cancer is early detection, because when caught early, colorectal cancer is highly curable. That’s why colorectal cancer screening is vitally important. Screening can detect cancers in their earliest stages, often before you experience any symptoms.
Colorectal cancer cases have been rising in adults under the age of 50, and a few years ago, the guidelines for screening changed to reflect that. The U.S. Preventive Services Task Force (USPSTF) now recommends an initial screening beginning at age 45 for those “who do not have signs or symptoms of colorectal cancer and who are at average risk for colorectal cancer.”
How is a colorectal cancer screening done?
There are several ways to screen for colorectal cancer. The gold standard and most thorough screening is a colonoscopy, a physical examination of the entire colon, using a flexible camera and performed by a physician. If you have a colonoscopy, you’ll need to follow a process to completely empty your bowel so the physician can clearly see inside your bowel, examine the lining and check for any signs of cancer.
Another type of screening – a stool-based test – is something that you use at home and send to a lab for testing. These tests look at a small sample of your stool to check for blood or other cellular changes that could indicate cancer. You may find this more convenient, because you collect the sample yourself at a time and location most comfortable for you.
This type of screening is not as thorough as a colonoscopy, however. If the test comes back as abnormal, your doctor will want to follow up with a colonoscopy.
Advantages and disadvantages of at-home colorectal cancer screenings
If you are considering using an at-home test for your colorectal cancer screening, here are some things to consider:
- Screening frequency. Because stool-based tests are not as thorough as colonoscopies, you need to have the screening done more often – annually for a stool-based test versus every five or 10 years for a colonoscopy.
- Types of at-home tests. There are several types of stool-based screening tests, and some are not recommended by the USPSTF. Check with your physician to see which type of test is recommended for you and check with your health plan to make sure the at-home test is covered.
- Accuracy. While at-home tests are more convenient, they also are less accurate. You are more likely to have false-positive results, requiring additional follow-up testing. In addition, at-home tests can miss indicators like polyps or other physical changes.
Your colon cancer risk level
If you have symptoms, a family history of colon cancer or other risk factors for colorectal cancer, your primary care provider (PCP) may recommend a colonoscopy over an at-home test to screen for colon cancer.
Talk with your PCP about your preferences and your health history to come up with the right plan for you.
Image: Getty Images
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