New Colon Cancer Screening Recommendations: What You Need to Know

Colorectal cancer will kill almost 50,000 Americans this year, but despite Katie Couric's best efforts, most adults aren't getting the recommended screening tests for the disease. Yesterday a handful of medical groups, including the American Cancer Society, put their stamp of approval on two additional tests to screen for the disease, including the so-called virtual colonoscopy. Yet all screening tests are not created equal, and all have their pluses and minuses. Here's the lowdown on the new recommendations, which are for average Americans, not those at greater risk because of family history or other factors.

What's new here?
Two tests are now being recommended: the virtual colonoscopy, which is an external CT scan that visualizes the colon without snaking a tube into it, and a stool test that detects mutated DNA shed from tumors. Those join the previously recommended screening tests, which include colonoscopy, sigmoidoscopy (in which a flexible tube is inserted in the rectum but not as far into the large bowel as with a colonoscopy), and different varieties of stool tests.

Which do the doctors recommend?
Any screening is better than none. But the guidelines say the best option is one that can pick up precancerous polyps, not just early signs of cancer. Those preferred tests are colonoscopy every 10 years, sigmoidoscopy every five years, double-contrast barium enema every five years, or virtual colonoscopy every five years.

Why would I opt for the regular colonoscopy if I could get a virtual one?
First, most people report that the worst part of the colonoscopy is the bowel-cleansing prep, and you still have to do that with a virtual test. The virtual test is also somewhat invasive—your colon is filled with air via a short tube in the rectum. If significant polyps are spotted, you will have to have a regular colonoscopy to remove them, and doing so immediately may not be possible—which would mean a repeat of the bowel prep on another day. Finally, virtual colonoscopy isn't usually covered by insurance, though that may change with this endorsement.

When do I have to worry about all this?
When you turn 50, if you're at average risk. If you have a family history of colon cancer, your doctor may recommend you start earlier.