Your Colonoscopy Escape Plan (Sort Of)

Ok. So it’s March. Colon Cancer Awareness Month.

We’ve already talked about colonoscopies. We’ve also talked about some of the less glamorous side effects of anesthesia. Apparently, I have chosen this month to become your friendly neighborhood poop-and-propofol correspondent, so let’s move on to alternatives to the colonoscopy.

Illustration of the human digestive system, highlighting the structure and arrangement of the intestines within the abdominal cavity. Image created by AI.

If some of you hear the word colonoscopy and immediately start mentally drafting your living will these are for you.

1. FIT Testing

FIT (fecal immunochemical test) is an at-home stool test.

Yes. You poop. You sample it. You mail it.Modern medicine is beautiful.

It’s done once a year and checks for human blood in the stool (as opposed to the previous fecal occult testing which tested for all types of blood including one that may be present in the steak you ate the night before).

Now, important caveat: it is not as good as a colonoscopy. Remember, if a colonoscopy finds a polyp, it can usually be removed right then and there. That’s the real flex of colonoscopy—it’s not just detective work, it’s also cleanup.

An envelope sitting in a mailbox representing sending your stool sample through the mail delivery system. Image created by AI.

If a FIT test comes back positive, that does not automatically mean cancer. It just means… congratulations, you’ve unlocked the next level: colonoscopy.

2. FIT-DNA Testing (aka Cologuard)

This is the one most people know as Cologuard.Yes, the one with the aggressively cheerful box that acts like mailing your poop is a fun little craft project. There is a good SNL skit about this if you’re in a “poopy mood”. (Oh gosh- let this month of teenaged bathroom jokes end).

Like FIT, it’s an at-home stool test. But it’s a bit fancier. It looks for blood and abnormal DNA that can be associated with colon cancer or precancerous polyps.

Compared to FIT alone, Cologuard is less likely to miss something, which is great.But… it also gets a little more dramatic with age, meaning false positives go up as you get older.

Cologuard needs to be repeated every 3 years.

Important: FIT and Cologuard are for people at average risk only. If you’ve had polyps, a strong family history, colon cancer, symptoms (bleeding, change in bowel habits) or inflammatory bowel disease, this is not the time to get cute with the stool box. You need to talk to your doctor about a real plan.

A blue and white box sits on a cozy front porch, resembling the distinctive colors of a Cologuard package ready for collection. Image created by AI.

A Few Other Options That Exist… But I’m Not Exactly Writing Them a Love Letter

3. Flexible Sigmoidoscopy

This is similar to a colonoscopy in that it uses a tube with a camera.

Fun!

It’s done in the office without anesthesia, which sounds convenient… until you remember you are fully awake while someone is investigating part of your large intestine like it owes them money.

The bigger issue: it only looks at the left side of the colon.So the transverse and right side? Totally uninvited to the party.

It’s repeated every 5 years, or every 10 years if paired with annual FIT testing.

And if they find anything abnormal?Say it with me now: you still need a colonoscopy.

Personally, this one has always felt like a weird compromise. It’s kind of like saying, “Good news! We inspected half the basement.”Cool. What about the other half where the raccoons and their babies are unpacking and moving in?

4. CT Colonography (Virtual Colonoscopy)

This one is often called a virtual colonoscopy, which sounds sleek and futuristic.

It is… less futuristic than it sounds.

You still must do the bowel prep. So yes, you still spend quality time with your toilet, questioning your life choices and the concept of broth AND green Jello (it doesn’t have to be green; that’s just the color that has been permanently etched into my brain).

Then a small tube is inserted so your colon can be inflated with gas, and imaging is done to look for polyps or cancer.

So, while technically no scope is snaking all the way through your colon… we are still very much not at the spa.

If anything is abnormal?That’s right. You still need a colonoscopy.

This test is repeated every 5 years.

A modern CT scan machine in a healthcare facility, ready for medical imaging procedures. Image created by AI.

Final thoughts

Here’s the deal: the best colon cancer screening test is the one you will actually do.

Is colonoscopy still the gold standard? Yes.

Why? Because it doesn’t just find problems—it can actually prevent cancer by removing polyps before they turn into cancer. That is a pretty big win for one weird little procedure.

But if the idea of anesthesia, prep, or someone taking a camera tour of your colon makes you want to hide in the attic, then an alternative screening test is still far better than doing nothing.

Colon cancer is one of the few cancers where we can often catch trouble before it becomes actual cancer. In addition, treating the earlier you find the colon cancer the easier the treatment will be. That’s amazing. That’s powerful. That’s worth a mildly humiliating stool-related inconvenience.

Pick a test. Get screened. Save your colon.

Because I promise you, colon cancer is a lot more unpleasant than mailing your poop.

(And remember the technical term is POOP, not POO).

A cheerful poop emoji with a big smile and rosy cheeks against a light pink background. Representative for the importance of colon cancer screening. Image created by AI.