Colorectal Cancer Screening Options

UW Health recommends the following colorectal cancer screening options for individuals age 50-75. After age 75, individuals should talk with their primary care provider about screening recommendations that are best for them.

 

View the brochure version of the following screening options: You Have the Power Brochure (pdf)

 

Vea la versión del folleto para las opciones siguientes de detección: Prevención del Cáncer Colorrectal (pdf)

 

Options sorted alphabetically by test type

 

Tests in the Clinic
Test Type Description Frequency Advantages Considerations
Optical Colonoscopy 
(Screens entire colon)
The rectum and entire colon are looked at using a flexible tube with a built in camera and light called a colonoscope. Abnormal growths can be found and removed or biopsied. Every 10 years • Can look at entire colon and rectum 
• Allows for removal of polyps at time of exam
• Sedation used for comfort

• Bowel preparation is required

• Low likelihood of not detecting (missing) small polyps and cancers 

• Sedation with recovery time; may miss work/activities
• Need a driver to take you home

Virtual Colonoscopy 
(Screens entire colon)
A CT scan of the abdomen is done while air (CO2) is put into the colon. Special computer software builds a 3-D model of the entire colon and rectum which is viewed by a radiologist to look for colon polyps and cancer. Every 5 years • Can look at entire colon and rectum 
• You can return to work/activity following the test, unless optical colonoscopy is required 
• No IV or sedation required

• Bowel preparation is required 

• Low likelihood of not detecting (missing) small polyps and cancers 

• If a polyp is found, removal may be done with optical colonoscopy the same day 

• A limited look at other internal organs seen on the CT images is also done 
• No driver needed to take you home

Flexible Sigmoidoscopy 
(Screens part of the colon)
The examiner uses a flexible, lighted tube (endoscope) to view the lining of the lower third of the colon and rectum. Every 5 years • Less bowel preparation is needed than colonoscopy 
• You can return to work/activity following the test 
• No IV or sedation is usually required
• Entire colon is not screened 
• If a polyp is found, an optical colonoscopy is scheduled to remove the polyp and look at the entire colon 
• No driver needed to take you home
Tests at Home
Fecal Immunohistochemical Test (FIT) This test checks for invisible blood in the stool. The test can be completed at home by collecting one stool sample. If the result is positive, this may be due to a polyp or cancer and more testing is needed. Every year
• No bowel preparation is needed
• Stool sample may be collected at home after test is ordered by your primary care provider 
• Most affordable option for uninsured patients. Contact the UW Health Price Information Line at (608) 263-1507 to get an estimated cost.
• Does not detect harmful polyps at an early, potentially pre-cancerous stage 
• Fails to detect some polyps and cancers (false negatives) and can have positive results even when there is no cancer (false positives)
• Colonoscopy is needed if test is positive 
Multitarget Stool DNA (FIT-DNA) This test checks for elevated levels of altered DNA and/or blood in the stool. If the result is positive, this may be due to a polyp or cancer and more testing is needed. Every 1-3 years*
• No bowel preparation is needed
• Stool sample may be collected at home after test is ordered by your primary care provider 

• Better at detecting polyps and cancers than FIT, but less likely than colonoscopy to detect harmful polyps and cancers

• Higher false positive rate than FIT (positive results despite no harmful polyps or cancers)

• Colonoscopy is needed if test is positive 

 

*Interval for re-screening using FIT-DNA is not clear (3 year interval based on modeling data by manufacturer).