Table 2.

Specific Attributes of Tests for Colorectal Cancer Screening

AttributesMean Ranka
DCBE = double-contrast barium enema; COL = colonoscopy; FOBT = fecal occult blood test; FS = flexible sigmoidoscopy.
a All significant at P <.001.
Accuracy
This test can find 24 to 50 of 100 cancers or advanced growths (FOBT)3.580.63
This test can find 95 of 100 cancers or advanced growths (COL)1.22
This test can find 70 to 80 of 100 cancers or advanced growths (FS)2.18
This test can find 40 to 50 of 100 cancers or advanced growths (DCBE)3.02
Amount of colon examined
The colon is not examined directly (FOBT)2.770.64
The entire colon is examined with these tests (COL, DCBE)1.18
The lower third of the colon is examined with this test (FS)2.04
Complications
There are no complications with this test (FOBT)1.520.38
For every 20,000 tests, 40 to 60 may result in a serious complication For every 100,000 tests done, 5 complications may result in death (COL)3.33
For every 20,000 tests, 1 may result in a serious complication (FS)2.20
For every 20,000 tests, 2 may result in a serious complication. For every 100,000 tests done, 1 to 2 complications may result in death (DCBE)2.94
Cost and Insurance coverage
The cost of the test is $10 to$25. Most insurance plans cover the cost of this test, and if you have Medicare you pay nothing (FOBT)1.870.15
The cost of the test is $800 to$1,600. Most insurance plans cover the cost of this test. If you have Medicare, you pay about $42 after Part B deductible (COL)2.90 The cost of this test is$150 to $300. Most insurance plans cover the cost of this test. If you have Medicare, you pay about$12 after Part B deductible (FS)2.32
The cost of the test is $250 to$500. Most insurance plans cover the cost of this test. If you have Medicare, you pay about \$28 after Part B deductible (DCBE)2.90
Discomfort
There is no discomfort with this test (FOBT)1.350.50
If you have this test, you will experience cramping abdominal pain, diarrhea, and gas before and after the test but not during the test (COL)1.91
If you have these tests, you will experience cramping abdominal pain, diarrhea, and gas before, during, and after the test (FS, DCBE)2.74
Frequency
It is recommended that you have this test done every year (FOBT)2.150.07
It is recommended that you have this test once every 10 years (COL)2.82
It is recommended that you have this test once every 3 to 5 years (FS)2.26
It is recommended that you have this test once every 5 to 10 years (DCBE)2.76
Location and person performing test
The test is done by you at home, and a laboratory technician checks the cards (FOBT)2.400.08
The test is done in the hospital by a physician specialist (COL)2.11
This test can be done by a primary care doctor or a physician specialist in a doctor’s office or in a hospital (FS)2.45
This test is done by a radiology technician in a hospital or outpatient facility DCBE)3.03
Need for further testing
If the test is abnormal, you would need to have another test (COL) to confirm the diagnosis (FOBT, FS, BE)1.730.21
There is no need for further tests with this test (COL)1.27
Need for sedation
A shot to make you sleepy will not be given when you have this test (FOBT)2.730.20
A shot is given to make you sleepy (COL)1.81
A shot to make you sleepy will not be given when you have this test (FS)2.73
A shot to make you sleepy will not be given when you have this test (DCBE)2.73
Preparation for the test
For 5 days before the test, you cannot eat red meat, certain fruits and vegetables, or vitamin C. You can take your medications (FOBT)2.360.04
For 7 days before the test, you can’t take aspirin, Motrin, Advil, iron or vitamins. The day before the test, you can only have a clear liquid diet. The night before this test and between 5 and 6 on the morning of the test, you drink a glass of solution and 6 to 8 glasses of clear liquids that cause diarrhea, which empties your colon. On the day of the test, you cannot eat breakfast but can take your medications (COL)2.77
After midnight on the night before the test, you cannot eat or drink anything. One hour before the test, you need to give yourself 2 enemas, which cause diarrhea and empty your colon. An enema is when you place liquid medicine into your bottom. On the day of the test, you cannot eat breakfast but can take your medications (FS)2.71
The day before the test, you can only have a clear liquid diet. The night before and on the morning of the test, you drink a solution that causes diarrhea, which empties your colon. On the day of the test, you cannot eat breakfast but can take your medications (DCBE)2.16
Scientific evidence
Scientific studies show that having this test regularly in people aged 50 to 80 years will reduce the number of deaths from colon cancer (FOBT)1.220.59
The scientific evidence is still being evaluated for these tests. There are as yet no studies showing that use of these tests reduce deaths from colon cancer (COL, DCBE)2.75
Scientific studies suggest that regular testing after the age of 50 years might reduce deaths from colon cancer (FS)2.02
Time for test
Time required for the test is a few minutes on 3 separate occasions. You will not miss time off from your regular activities (FOBT)1.680.09
It takes 45 minutes to have this test, but you will need a whole day off from your regular activities (COL)2.29
It takes about 30 minutes to have either of these tests. You will need half a day off from your regular activities (FS, DCBE)2.03
Patient’s responsibilities
When you decide to have this test, you will have to alter your diet, pick up the test kit, put a sample of your bowel movement on the cards, and mail them or bring them to the laboratory (FOBT)2.070.06
When you decide to have this test, you will have to alter your diet, make an appointment, buy the solution, and take the solution at home according to the instructions. You need to bring a responsible adult who can drive you home (COL)2.48
When you decide to have this test, you will have to alter your diet, make an appointment, buy the enema solution, and give yourself the enemas at home according to the instructions (FS)2.82
When you decide to have this test, you will have to alter your diet, make an appointment, buy the solution, and drink it at home according to the instructions (DCBE)2.63