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Philadelphia Inquirer: Colonoscopy isn’t the only way to screen for colon cancer. Here are your options

From The Philadelphia Inquirer: In a study published in the Journal of General Internal Medicine last year, Shivan Mehta, a gastroenterologist and associate chief innovation officer at Penn Medicine, and his colleagues found that mailing at-home test kits to patients increased screening compliance tenfold.

Through a text message “opt-out” system, patients were notified that they’d be receiving a test kit — unless they said they didn’t want one.

The two most popular types of at-home tests are:

  • Fecal immunochemical tests (FIT), which require the user to collect a stool sample and send it to a lab, where it is tested for hidden traces of blood. Blood in stool is one potential sign of colon cancer.

  • Stool DNA test, which analyzes a stool sample taken at home and sent to a lab for DNA changes that could indicate colon cancer.

Both types of tests are done at home with little or no preparation and are noninvasive. And if you’re paying out of pocket, FIT kits can cost as little as $25. The most well-known stool DNA test, Cologuard — that’s the one you may have seen on TV — costs about $600.

FIT tests must be repeated annually, while stool DNA tests are done every three years. Medical experts say people who have a higher risk of colon cancer (for instance, if they have a family history) should stick with colonoscopies. And if the home test detects something unusual, patients will need to have a colonoscopy to find out what’s happening.

In the past, insurers could bill patients who got a suspicious result from a home test for the follow-up colonoscopy, because it was deemed diagnostic — performed to get more information on a known problem — rather than considered a screening test. Federal guidelines have recently clarified that a colonoscopy needed as follow-up to an at-home screening test should be considered part of the screening process, but Mehta and Samir urged people to check with their insurance company to confirm how their plan covers such scenarios.

Read more in The Inquirer.