Optimal Noninvasive Colon Cancer Screening Modality in Patients Not Receiving Colonoscopy

Colon cancer is the third most common among cancer deaths in the US for both men and women. The incidence of colonoscopy has been soaring in younger patients, which led to changes in recent United States Preventive Services Task Force (USPSTF) guidelines to reduce the age for screening from 50 years to 45 years. Demand for colonoscopy services is surging due to increased incidences of colorectal cancer (CRC) in the both aging and younger population. Increased referrals have led to an insufficient workforce in hospitals and long waiting lists. Further, results from colonoscopy reveal a low percentage of CRC or another severe bowel disease (SBD). Therefore, colon cancer screening is a growing concern, particularly in patients who otherwise have a very long-life expectancy, and who are most likely to benefit from screening. Another reason to boost CRC screening is to minimize the load on hospitals by reducing the patients that undergo colonoscopy unnecessarily because only a low percentage of CRC occurrence is observed in individuals undergoing colonoscopy. In recent years, there are a variety of screening options available for CRC. Noninvasive alternatives include fecal immunochemical test (FIT), multitarget stool DNA testing (MT-sDNA, available under the brand name Cologuard), computed tomography (CT) colonography (previously called virtual colonoscopy), guaiac-based fecal occult blood testing (gFOBT), and capsule colonoscopy (CC). These tests have varied the degree of evidence supporting their use. This study focuses on the most recent survey and efficacy of noninvasive methods to prevent and detect colorectal cancer (CRC).