Screening Comparison

There are five main screening methods for colorectal cancer.  At The Center for Colorectal Health, we use the fecal occult blood test (FOBT), the only non-invasive method available.  It serves as an excellent initial screening due to its safe, simple and inexpensive nature.  For accurate results, hemorrhoids and anal fissures must be treated and resolved prior to FOBT screening to eliminate any known causes of blood in the stool.

Digital Rectal Exam

• PRO:  Inexpensive; requires no instrumentation
• CON:  Unable to screen for the majority of polyps

Fecal Occult Blood Test (FOBT)

• PRO:  Non-invasive; inexpensive; convenient; safe; simple
• CON:  Not specific; false positives; some polyps don’t bleed; dietary restrictions

Colonoscopy

• PRO:  Gold standard sensitivity;  polyps can be removed for testing
• CON:  Expensive;  sedation required; risk of perforation; dietary restrictions

Sigmoidoscopy

• PRO:  Same pro’s as colonoscopy plus: sedation rarely required; faster procedure
• CON:  Upper two thirds of colon cannot be screened; risk of perforation

Double-contrast Barium Enema (DCBE)

• PRO:  No sedation required; lower cost and less recovery time than colonoscopy
• CON:  Less sensitive than colonoscopy; polyps cannot be removed for testing

Two emerging methods—DNA stool testing and virtual colonoscopy—have not yet been endorsed for screening and are not covered by Medicare or most major carriers.