About 1 in 3 adults ages 50 to 75 have never been screened for colon cancer or isn’t up-to-date with recommended screenings. Screening lowers the risk of death from colon cancer, and experts encourage people with no family history to start regular screening at age 50.
Many people assume that screening means a colonoscopy, but other approaches—like various stool-based tests, either alone or combined with flexible sigmoidoscopy—are reasonable options, too. Shared decision making (SDM) can help people understand the benefits and risks of screening and choose the approach that’s right for them.
In fact, when the U.S. Preventive Services Task Force (USPSTF) recently updated their guidelines on screening for colorectal cancer, they didn’t recommend one test over another. Instead, the expert panel said, “The best screening test is the one that gets performed.”
The two basic approaches to screening (colonoscopy, or stool-based testing with or without flexible sigmoidoscopy) vary in how much time they take, what they involve for the patient, and how often they need to be performed.
So which screening test is most likely to get performed? Probably the test that the patient finds most acceptable. To be an equal partner in the decision, the patient has to know she has options and think about which approach will work best for her.