Home stool tests for colorectal cancer screening are growing in popularity, but are they right for you?

Home stool tests may be an easier way to screen for colorectal cancer than a dreaded colonoscopy. As cancer rates continue to rise in young people, home testing could help improve detection and get people treated earlier.

March marks the start of Colorectal Cancer Awareness Month. Colorectal cancer is the third most commonly diagnosed cause and third leading cause of cancer death in the United States, according to the American Cancer Society. Diagnosis of the disease is on the rise among young people under the age of 55, according to a new study from the ACS, and it is being diagnosed at later stages.

That’s why the American Cancer Society reminds people that any colorectal cancer screening can save lives. Adults at average risk should get tested starting at age 45, according to the US Preventive Services Task Force.

“Identifying cancers earlier makes treatment much easier,” Dr. Jeffrey Farma, surgical oncologist and acting chair of surgery at Fox Chase Cancer Center, told ABC News.

Home stool testing, where people collect stool samples and send them to a lab, can help make the process easier for some people. Here’s how to know if this is a good option for you.

Who is a good candidate for home stool tests?

The first step is to discuss with your doctor whether you are eligible for home stool tests given your family and medical history.

Only people at “medium” risk for colorectal cancer – who don’t have a family or medical history that puts them at high risk – can use the tests. High-risk people aren’t eligible, experts say.

People at high risk are those who have colon cancer in a first-degree relative (such as parents or siblings), or a personal or family history of a higher-risk polyp in the colon or rectum . These people should “only get screened by colonoscopy,” Dr. Fola May, a gastroenterologist, chief quality officer and health equity researcher at UCLA Health, told ABC News.

Other people at high risk for colorectal cancer are those with inflammatory bowel disease such as Crohn’s disease or ulcerative colitis, and people with genetic conditions that put them at risk for cancer.

People at increased risk may need to start colorectal cancer screening earlier and get tested more often.

What stool tests are available at home?

There are several home stool-based tests.

These tests check stool for signs of cancer such as blood, unusual changes in DNA, or both. There are several types of tests. Some, like the fecal immunochemical test, are done every year. Others, like stool DNA testing, only need to be done every three years.

Companies offering these tests include Cologuard, Labcorp or QuestDirect. Talk to your doctor about which one is right for you.

What are the pros and cons of home testing?

The biggest advantage of home stool tests is that they can be done from the comfort of your own home.

This convenience is one of the reasons the colorectal cancer screening rate was stable in the second year of the pandemic, according to a recent study, even when rates for other types of cancer screening declined. “The pandemic has got everyone thinking about more practical or person-centered ways to complete cancer screening,” Dr. Arif Kamal, patient manager for ACS, told ABC News.

Also, unlike a colonoscopy, home stool tests don’t require patients to take the unpleasant step of emptying their bowels with fluids, pills, enemas, or some combination. Patients also won’t need sedation or need to miss a day of work to get the stool tested.

Although not leaving your house adds great appeal to home stool tests, they are not always as accurate as a colonoscopy. They can miss many polyps and some cancers. Some stool-based tests can also be affected by your diet or the medications you take.

Is a colonoscopy still necessary?

Doctors point out that while these home stool tests may be more convenient and done from the comfort of home, if any of these tests are abnormal, you’ll still need a colonoscopy.

“If you don’t go through that second step, the colonoscopy, you haven’t completed the screening process and you’re more likely to get and die from colorectal cancer,” May says.

You should also talk to your doctor about rapid colorectal cancer screening if you have changes in your bowel habits, blood in your stools, diarrhea, constipation, a feeling that your bowel is not emptying completely, pain abdominal muscles, body aches, cramps that do not go away. , or unexplained weight loss, according to the Centers for Disease Control and Prevention.

Get tested, in any way

The ACS estimates that in 2023, approximately 153,020 people will be diagnosed with colorectal cancer in the United States and 52,550 people will die from the disease, including 19,550 cases and 3,750 deaths among people under age 50.

Colonoscopies are the gold standard for colorectal cancer screening, but experts say any test is better than no test – that’s where home stool testing comes in.

“The best cancer screening is the one that is done,” Kamal said.

Kimberly Loo, MD, is an internal medicine resident at New York-Presbyterian/Weill Cornell Medical Center and a contributor to the ABC News Medical Unit.

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