At-home colon cancer screening tests: Discreet convenience

Colorectal cancer is when a tumor forms in the rectum or colon. Screening can help doctors find the cancer or precancerous polyps early when treatment might be more effective.

At-home screening kits can detect evidence of colorectal cancer. You do not need a prescription to buy one, and you can often find them in-store at pharmacies or online. If you receive a positive result, these testing services will typically recommend that you follow up with a doctor or healthcare professional for further investigation.

About at-home colon cancer screening tests 

The U.S. Preventive Services Task Force (USPSTF) recommends regular colorectal cancer screening for people ages 45–75 years.

You have a few options if you want to take a colon cancer screening test at home. The Centers for Disease Control and Prevention (CDC) lists three types:

• Guaiac-based fecal occult blood test (gFOBT): You get this at-home kit from a healthcare professional. You use a small stick or brush tool to get a stool sample and return the sample to a lab or doctor’s office.
• Fecal immunochemical test (FIT): You can get this kit without a doctor’s prescription. Examples are the ColoFIT test, which you can buy online. You take a stool sample similar to a gFOBT and send it to a lab. The FIT test looks for blood in the stool.
• FIT-DNA test: You can also buy this kit without a prescription. The brand name is Cologuard, and you collect a stool sample and send it to a lab. The FIT-DNA test looks for blood and altered DNA in the stool. 

A 2020 study of the FIT test in people with bowel-related symptoms found the test to have a high degree of accuracy, as it detected the presence of cancer in nearly every instance. Of the 743 people who had a negative FIT test, 0.9% had a colorectal cancer diagnosis, 2.6% had a higher likelihood of polyps, and 3.5% had colitis.

According to the American College of Surgeons, a 2019 study showed that 91,297 people had either the FIT or FIT-DNA tests that detected cancer at similar rates, including at an early stage.

Following up with a doctor 

After you take an at-home screening test and send the sample for analysis, the lab will send you the results. Typically, the results are only sent to a healthcare professional if they order the test themselves or you return the sample to a doctor or clinic. 

If you receive a positive lab result, the next step is to follow up with a doctor. They will usually recommend a colonoscopy, where a doctor uses a thin tube to check for polyps or cancer in the colon. The doctor can usually remove polyps during the procedure.

One benefit of getting a colonoscopy after a positive lab result is the earlier detection and treatment of colorectal cancer. A 2022 study of 111,423 people with positive FIT results found those who did not get a follow-up colonoscopy had more than double the risk of end stage colorectal cancer compared to those who did.

About colorectal cancer 

In 2023, there were an estimated 153,020 new cases of colorectal cancer in the United States. This accounts for 7.8% of all new cancer cases. Among the risk factors for colorectal cancer are:

• your age, as your risk for colorectal cancer increases as you get older
• having an inflammatory bowel disease like Crohn’s disease or ulcerative colitis
• family history of colorectal cancer or polyps
• specific genetic syndromes
• not enough physical activity
• low fiber and high fat diets
• alcohol and tobacco use
• obesity

Screening for colorectal cancer allows doctors to detect the condition early so it has a better chance of responding to treatment. Tests such as colonoscopy can also allow a doctor to remove polyps and other tissue before it becomes cancer.

For someone at average risk of colon cancer, most experts recommend screening starting at age 45–50 years. If you are at a higher risk, a healthcare professional may recommend screening at a younger age and getting tested more frequently.

Screening options include:

• stool tests, like FIT, FIT-DNA, or gFOBT
• colonoscopies, where a doctor examines the rectum and the entire colon using a lighted tube
• sigmoidoscopies, where a doctor examines the rectum and lower colon (sigmoid colon) using a lighted tube
• virtual colonoscopies, where a doctor uses a CT scan to examine the colon

Preventing colorectal cancer

Alongside screening, some ways that may help reduce your risk for colorectal cancer include:

• eating a diet high in fruits, vegetables, and whole grains
• limiting animal fats
• increasing physical activity if possible
• maintaining a moderate weight
• stopping smoking if you smoke
• limiting alcohol, if you drink it

Summary

At-home colorectal cancer screening kits include the FIT, FIT-DNA, and gFOBT tests. Healthcare professionals recommend people ages 45–75 years get regular testing, as early detection can help reduce the risk of death from colon cancer. 

After a positive test result, you should consider contacting a doctor or healthcare professional to arrange follow-up testing.

Follow-up tests can include include a colonoscopy, sigmoidoscopy, or CT scans. A healthcare team can discuss all the results with you and go over the next steps.

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