Colorectal Screening Tests: Pros and Cons

Our colon cancer screening tests chart makes it easier for you to compare the most frequently used exams.

From The National Cancer Institute

Test		Advantages		Disadvantages
Fecal Occult Blood Test (FOBT)		No preparation of the colon is necessary. Samples can be collected at home. Cost is low compared to other colorectal cancer screening tests. FOBT does not cause bleeding or tears in the lining of the colon.		This test fails to detect most polyps and some cancers. False positive results are possible. ("False positive" means the test suggests an abnormality when none is present.) Dietary and other limitations, such as increasing fiber intake and avoiding meat, certain vegetables, vitamin C, iron, and aspirin, are often recommended for several days before the test. Additional procedures, such as colonoscopy, may be necessary if the test indicates an abnormality.
Sigmoidoscopy		The test is usually quick, with few complications. Discomfort is minimal. In some cases, the doctor may be able to perform a biopsy (the removal of tissue for examination under a microscope by a pathologist) and remove polyps during the test, if necessary. Less extensive preparation of the colon is necessary with this test than for a colonoscopy.		This test allows the doctor to view only the rectum and the lower part of the colon. Any polyps in the upper part of the colon will be missed. There is a very small risk of bleeding or tears in the lining of the colon. Additional procedures, such as colonoscopy, may be necessary if the test indicates an abnormality.
Colonoscopy		This test allows the doctor to view the rectum and the entire colon. The doctor can perform a biopsy and remove polyps during the test, if necessary		The test may not detect all small polyps and cancers, but it is the most sensitive test currently available. Thorough preparation of the colon is necessary before the test. Sedation is usually needed. Although uncommon, complications such as bleeding and/or tears in the lining of the colon can occur.
Double Contrast Barium Enema(DCBE)		This test usually allows the doctor to view the rectum and the entire colon. Complications are rare. No sedation is necessary.		The test may not detect some small polyps and cancers. Thorough preparation of the colon is necessary before the test. False positive results are possible. The doctor cannot perform a biopsy or remove polyps during the test. Additional procedures are necessary if the test indicates an abnormality.
Digital Rectal Exam (DRE)		Often part of a routine physical examination. No preparation of the colon is necessary. The test is usually quick and painless.		The test can detect abnormalities only in the lower part of the rectum. Additional procedures are necessary if the test indicates an abnormality.

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