At Home Colon Cancer Test: Complete Guide to Screening Options

Colorectal cancer screening doesn’t have to mean scheduling a colonoscopy. At home colon cancer tests offer a convenient, private, and effective way to screen for one of the most preventable cancers. These tests allow you to collect samples in the comfort of your home and can detect early signs of colorectal cancer when treatment is most successful.

Understanding your screening options empowers you to take control of your health. This comprehensive guide explores at home colon cancer tests, how they work, their benefits and limitations, and how to choose the right screening method for your needs.

Understanding Colon Cancer Screening

Colon cancer screening is a preventive health measure designed to detect cancer or precancerous polyps in the colon and rectum before symptoms appear. Regular screening is one of the most powerful tools for preventing colorectal cancer deaths.

Screening is recommended for people at average risk starting at age 45. Those with a family history of colorectal cancer, inflammatory bowel disease, or certain genetic syndromes may need to start screening earlier and more frequently.

While colonoscopy has long been considered the gold standard for colorectal cancer screening, it requires bowel preparation, sedation, time off work, and someone to drive you home. At home colon cancer tests provide an alternative that fits more easily into busy lifestyles.

Types of At Home Colon Cancer Tests

Three main types of at home colon cancer tests are available, each with different methods of detecting signs of cancer or precancerous polyps.

Fecal Immunochemical Test (FIT)

The fecal immunochemical test, commonly known as FIT, is one of the most widely used at home screening options. This test detects hidden blood in your stool using antibodies that react specifically to human hemoglobin from the lower digestive tract.

How FIT works:

• Requires no dietary restrictions or medication changes before testing
• You collect a small stool sample from a single bowel movement
• The sample is placed in a collection container provided in the kit
• You mail the sample to a laboratory for analysis
• Results are typically available within two weeks
• Should be repeated annually

FIT is highly specific for bleeding from the colon and rectum, which means it’s less likely to produce false positives from bleeding in the upper digestive tract or from dietary sources.

Guaiac Fecal Occult Blood Test (gFOBT)

The guaiac fecal occult blood test is an older method that also detects hidden blood in stool. It uses a chemical reaction to identify hemoglobin, but it can detect blood from anywhere in the digestive tract.

How gFOBT works:

• May require dietary restrictions before testing, including avoiding red meat, certain raw vegetables, and vitamin C supplements
• You collect samples from three consecutive bowel movements
• Samples are smeared onto special cards included in the kit
• Cards are mailed to a laboratory for testing
• Should be repeated annually

While gFOBT is less expensive than other options, it has a higher rate of false positives and requires more preparation and multiple samples.

Multitarget Stool DNA Test (mt-sDNA)

The multitarget stool DNA test, marketed as Cologuard, represents the most advanced at home screening option. This test detects both hidden blood and altered DNA shed from cancer cells and precancerous polyps.

How stool DNA testing works:

• Requires no dietary or medication restrictions
• You collect an entire bowel movement in a special container
• A preservative solution is added to the sample
• The container is shipped to the laboratory in provided packaging
• Results are typically available within two weeks
• Should be repeated every three years if results are negative
• Only available by prescription from your healthcare provider

The stool DNA test has higher sensitivity for detecting colorectal cancer and advanced adenomas compared to blood-only tests, but it also has a higher rate of false positives.

How At Home Colon Cancer Tests Detect Cancer

At home colon cancer tests work on the principle that cancers and precancerous polyps often bleed or shed abnormal cells into the stool. Even if this bleeding is microscopic and invisible to the naked eye, specialized tests can detect these warning signs.

Colorectal tumors develop abnormal blood vessels that are fragile and prone to bleeding. As stool passes through the colon, it may come into contact with these growths, causing small amounts of blood to mix with the stool.

Additionally, cancer cells and precancerous polyps shed DNA into the stool. This DNA contains genetic mutations and methylation patterns that differ from normal cells. Stool DNA tests can identify these molecular markers, potentially detecting cancer before significant bleeding occurs.

Benefits of At Home Colon Cancer Testing

At home colon cancer tests offer several advantages that make screening more accessible:

• Convenience: Complete the test on your schedule without taking time off work or arranging transportation
• Privacy: Collect samples in the comfort and privacy of your own bathroom
• No preparation: Most tests require no bowel cleansing or dietary restrictions
• No sedation: Avoid the risks and recovery time associated with anesthesia
• Cost-effective: Generally less expensive than colonoscopy, though follow-up colonoscopy may be needed for positive results
• Effective screening: Proven to reduce colorectal cancer deaths when used regularly
• Increased compliance: People are more likely to complete screening when convenient options are available

Limitations and Risks of At Home Tests

While at home colon cancer tests provide valuable screening, they have important limitations to consider:

Lower Sensitivity Than Colonoscopy

At home tests are less sensitive than colonoscopy for detecting polyps, especially small or flat polyps. Not all polyps bleed consistently, which means they may be missed by blood-based tests.

False Negative Results

A false negative occurs when the test indicates no cancer or polyps are present when they actually exist. This can happen if:

• Polyps or cancers don’t bleed at the time of sample collection
• Bleeding is too minimal to be detected
• The sample is not collected or handled properly

False negatives can provide false reassurance, potentially delaying diagnosis and treatment.

False Positive Results

A false positive occurs when the test indicates cancer or polyps may be present when they’re not. This can happen due to:

• Bleeding from hemorrhoids
• Bleeding from stomach ulcers or gastritis
• Inflammatory bowel disease
• Recent dental work or gum bleeding

False positives lead to unnecessary colonoscopies and associated anxiety.

Requires Follow-Up Colonoscopy

Any positive result from an at home test requires follow-up with colonoscopy to confirm findings and remove any polyps discovered. This means you may eventually need the procedure you hoped to avoid.

Comparing At Home Colon Cancer Test Options

Each type of at home test has different characteristics regarding accuracy, cost, and convenience:

Detection Rates

• Stool DNA test (mt-sDNA): Highest sensitivity for detecting colorectal cancer (92%) and advanced adenomas (42%)
• FIT: Good sensitivity for colorectal cancer (74%) and moderate sensitivity for advanced adenomas (24%)
• gFOBT: Lower sensitivity for both colorectal cancer and advanced adenomas compared to FIT and stool DNA tests

False Positive Rates

• FIT: Lowest false positive rate (5%)
• Stool DNA test: Higher false positive rate (13%)
• gFOBT: Moderate false positive rate, influenced by dietary factors

Cost Considerations

• FIT and gFOBT: Generally lower cost ($20-$40)
• Stool DNA test: Higher cost ($500-$600)
• Most insurance plans, including Medicare, cover approved colorectal cancer screening tests with no out-of-pocket cost

Testing Frequency

• FIT and gFOBT: Annual testing recommended
• Stool DNA test: Every three years if negative

Who Should Use At Home Colon Cancer Tests

At home colon cancer tests are appropriate for adults at average risk of colorectal cancer who:

• Are aged 45 or older
• Have no symptoms of colorectal cancer
• Have no personal history of colorectal cancer or polyps
• Have no family history of colorectal cancer
• Do not have inflammatory bowel disease
• Do not have certain genetic syndromes associated with colorectal cancer

When to Choose Colonoscopy Instead

Colonoscopy may be the better choice if you:

• Have a family history of colorectal cancer, especially in a first-degree relative
• Have symptoms such as rectal bleeding, abdominal pain, or changes in bowel habits
• Have had polyps removed previously
• Have inflammatory bowel disease
• Have a genetic syndrome that increases colorectal cancer risk
• Prefer the most comprehensive screening method
• Want to maximize the chance of detecting and removing polyps in a single procedure

How to Obtain an At Home Colon Cancer Test

Getting an at home test is straightforward:

Through Your Healthcare Provider

Your doctor can prescribe or provide test kits during routine visits. Many healthcare systems mail kits directly to patients who are due for screening.

Direct-to-Consumer Options

Some FIT tests are available over-the-counter at pharmacies without a prescription. However, the stool DNA test requires a prescription.

Insurance Coverage

Most health insurance plans, including Medicare and Medicaid, cover approved colorectal cancer screening tests with no copay or deductible when used according to recommended guidelines. Verify coverage with your insurance provider before ordering.

Tips for Accurate At Home Testing

Follow these guidelines to ensure reliable results:

• Read all instructions carefully before beginning sample collection
• Collect samples as directed – don’t collect too much or too little
• Avoid contamination – keep samples away from urine and toilet water
• Return samples promptly – most tests require mailing within 24 hours
• Follow dietary restrictions if using gFOBT
• Don’t test during menstruation or if you have bleeding hemorrhoids
• Store kits properly according to package directions

Understanding Your Test Results

Negative Results

A negative result means no blood or abnormal DNA was detected in your sample. This is reassuring, but remember that no screening test is 100% accurate. Continue regular screening according to your healthcare provider’s recommendations.

Positive Results

A positive result means blood or abnormal DNA was found in your sample. This does not necessarily mean you have cancer. Many positive results are due to polyps or other non-cancerous causes of bleeding.

Your healthcare provider will recommend a follow-up colonoscopy to examine your colon directly, identify the source of bleeding or abnormal DNA, and remove any polyps found.

Invalid Results

Sometimes tests cannot be completed due to inadequate samples, improper handling, or technical issues. You’ll need to repeat the test if results are invalid.

The Importance of Regular Screening

Colorectal cancer typically develops slowly over many years, progressing from normal tissue to polyps to cancer. Regular screening can detect and remove polyps before they become cancerous, effectively preventing cancer development.

Even when cancer is present, finding it early dramatically improves survival rates. The five-year survival rate for colorectal cancer detected at an early, localized stage is 90%, compared to just 14% when detected after it has spread to distant organs.

Despite the effectiveness of screening, many Americans are not up to date with colorectal cancer screening. At home tests help overcome barriers such as time constraints, transportation issues, and discomfort with invasive procedures.

Making Your Decision

Choosing the right colorectal cancer screening method depends on your individual circumstances, preferences, and risk factors. Consider these questions:

• What is my risk level for colorectal cancer?
• Do I have symptoms that need investigation?
• What are my insurance coverage and out-of-pocket costs for different options?
• How important is convenience versus comprehensive detection?
• Am I willing to undergo colonoscopy if my at home test is positive?
• Will I consistently complete annual testing if I choose a yearly test?

Talking to Your Healthcare Provider

Discuss your screening options with your healthcare provider. They can help you understand:

• Your personal risk factors for colorectal cancer
• Which screening test is most appropriate for your situation
• How often you should be screened
• What to do if you receive a positive result
• How to obtain test kits
• Insurance coverage and costs

Be open about your concerns, preferences, and barriers to screening. Your doctor’s goal is to help you find a screening method that you’ll actually complete, because the best screening test is the one that gets done.

The Future of At Home Colon Cancer Testing

Research continues to improve at home screening options. New technologies in development include:

• Blood tests that detect circulating tumor DNA
• More sensitive stool tests with improved DNA detection
• Artificial intelligence analysis of test results
• Simplified collection methods
• Faster turnaround times for results

These advances may further increase the accuracy and convenience of at home screening, helping more people protect themselves from colorectal cancer.

Taking Action

If you’re 45 or older and haven’t been screened for colorectal cancer, now is the time to take action. Don’t let fear, inconvenience, or misconceptions prevent you from this potentially life-saving test.

At home colon cancer tests make screening accessible, private, and convenient. While they may not be appropriate for everyone, they provide an effective option for many people at average risk.

Remember that colorectal cancer is highly preventable and treatable when caught early. Regular screening with any approved method – whether at home tests or colonoscopy – significantly reduces your risk of dying from this disease.

Talk to your healthcare provider today about which screening option is right for you. Your future self will thank you for taking this important step to protect your health.

Sources:

• National Cancer Institute – Colorectal Cancer Screening
• Centers for Disease Control and Prevention – Colorectal Cancer Screening Tests
• Mayo Clinic – Fecal Occult Blood Test
• American Cancer Society – Tests to Screen for Colorectal Cancer
• U.S. Preventive Services Task Force – Colorectal Cancer Screening