What’s this new at-home colon cancer test?

A: The at-home colon cancer screening test uses a self-collected stool sample to look for signs of cancer DNA. It is an effective and convenient screening test option for most people aged 45-75.

The at-home DNA test (marketed as Cologuard in the U.S. and Colo-Alert in Europe) is a newer option for colon cancer screening. It’s ordered by your clinician, and you receive a kit in the mail. Although collecting your own bowel movement isn’t particularly pleasant, the kit contains a bracket for your toilet seat and containers that make it easy and mess-free. You then label your sample, package it back up in the box, and send it via prepaid UPS to the testing company. Results are available within a week.

This test looks for two signs of potential colon cancer, blood and cancer DNA in the stool. This DNA part is some very cool new science! If either is detected, the test is “positive.” This happens in about 1 in 6 people. If it happens to you, the next step is a colonoscopy to take a direct look and sample any suspicious looking areas. Studies show that about 1 in 4 people with a positive DNA stool test will have cancer or pre-cancer in their colon. For the other 3 out of 4 people, the positive screening test was a false alarm, also known as a “false positive.” Their colonoscopies will show no signs of cancer or pre-cancer.

If the test is negative, you can be quite confident that you don’t have colon cancer, with a less than 1 in 1000 chance. No colonoscopy is needed, and you should simply repeat the stool DNA test in three years.

This test is convenient, as you can do it at home and at a time that works for you. You do not have to avoid certain foods or do anything special before collecting your sample. Since there is no medical procedure involved, there is no risk of complications. This new test is not yet widely covered in many countries, but is fully covered by most forms of health insurance in the U.S. If, however, you get a positive test result and need a colonoscopy, your insurance may or may not cover the full cost of that colonoscopy. Be sure to check your coverage in advance!

Many deaths from colon cancer can be prevented. Screening tests allow us to find cancer or precancer early on so that it can be successfully cured. These tests are now recommended for *everyone* ages 45-75. There are lots of different tests to choose from, including colonoscopy every 10 years, sigmoidoscopy every 5 years, stool tests for blood every year, and now stool tests for cancer DNA every three years. Discuss with your clinician which type of test will work best for you.

Note: People who are at increased risk for colon cancer due to family history or certain medical conditions need different tests and should discuss this with their clinician.

Bottom line : Everyone aged 45 through 75 should be screened regularly for colon cancer. The at-home stool DNA test, when performed every three years, is an effective and convenient option.