Is a Colonoscopy Your Only Testing Option?

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En español l A colonoscopy is the most accurate test to help prevent colon cancer, but the discomfort of the all-day laxative prep and the sedation — not to mention the actual procedure — cause millions to forgo the test every year. If you're one of the estimated 23 million American adults who have not been screened, there are some easier, albeit less accurate, alternatives.

With early detection so critical for stopping this type of cancer, however, "the best test is the one that gets done," says Mark Pochapin, director of gastroenterology at NYU Langone Medical Center. Note: If the test results are suspicious, you'll still need to undergo the real deal.

Virtual colonoscopy

Instead of using a scope in the rectum, this test employs a CT scan to view your colon. "Virtual colonoscopy is as good as traditional colonoscopy for finding large polyps," says Douglas K. Rex, distinguished professor of medicine at Indiana University Hospital. Smaller polyps and flat lesions may be more difficult to detect, though.

Pros: You won't need to be sedated.

Cons: It requires the same bowel-cleansing prep as colonoscopy, it exposes you to a small dose of radiation, and the $400-plus cost isn't covered by Medicare and many insurers.

Cologuard

This new test requires no prep and can be done in the privacy of your home. You simply take a sample of a bowel movement and mail it to a lab for analysis. The lab looks for both blood and cancer-related DNA in the stool.

Take-home fecal tests

The fecal occult blood test (FOBT) and fecal immunochemical test (FIT) both check for traces of blood in the stool, which could indicate cancer. Simply send a stool sample to a lab.

Pros: The $22 cost is covered by Medicare and insurers, and the FIT finds nearly 80 percent of colon cancers. Colonoscopy, by contrast, catches up to 90 percent of cancers.

Cons: You have to do it every year, instead of every 10 years for a traditional colonoscopy.

Sigmoidoscopy

Like a colonoscopy, this exam inserts a thin, flexible tube with a tiny camera into the rectum. It's best for those at low risk for colon cancer, meaning no family history and no previous polyps. You follow a clear liquid diet the day before you take the exam and take a laxative or enema that morning.

Pros: The test takes just 10 to 20 minutes and doesn't require sedation.

Cons: Because it examines only the lower colon, any polyps in the upper colon would go undetected. You also have to take the test every five years.

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