The American College of Physicians (ACP) recently announced new colon cancer screening guidelines. Basically, the ACP says colonoscopy isn’t your only choice if you’re not at high risk for the disease. (Colonoscopy is required, however, if you have symptoms, such as blood in your stool.) I wrote about other options in an article for AARP The Magazine
this past winter, such as the fecal immunochemical test (FIT) or Cologuard, a new DNA test you can get from your doctor. The FIT test finds 70% of colon cancers and the Cologuard 92% compared to 95% for colonoscopy. Colonoscopy is recommended every 10 years if normal, Cologuard every 3 years, and the FIT test yearly from ages 50 to 75.

A screening colonoscopy is covered as a preventive health service by most health insurance policies, as is the FIT test. Cologuard, which costs $599, has negotiated coverage through Medicare and is hoping to get private insurance coverage, too.

A few months ago, I went in search of the FIT, since colon cancer experts advised me that it was not the same as the drugstore guaiac tests you can get where you throw a chemically treated paper into the toilet after a bowel movement. “Those tests are not effective,” says Douglas K. Rex, M.D., distinguished professor of medicine at Indiana University Hospital. I asked my primary care doctor for the FIT, who told me to ask at a pharmacy. The pharmacy told me to ask my doctor. I asked my gynecologist, who told me to ask a gastroenterologist. Uh, no, I was trying to avoid spending extra money by seeing a specialist.

Finally, I found an FIT online this spring from Pinnacle Biolabs. It cost $25 for two tests and was simple to perform and read. You gather a small amount of stool onto a wand and place it into a vial of liquid. You shake the vial and then place three drops of liquid onto a test panel. The results show up within 5 minutes.

So, if assuming you’re at average risk for colon cancer and you’re not willing to have a colonoscopy, try the yearly FIT test. But be sure you’re getting an FIT and not the guaiac test.