There are multiple ways to detect colorectal cancer early; colonoscopies are just the end of the line

As the 1977 international bestseller by Tarō Gomi says… everybody poops. 

And as the United States Preventive Services Task Force says… if you have abnormal results from a stool-based colorectal cancer screening test, you should then follow up with a colonoscopy.

When people think of colorectal cancer, they likely think of the colonoscopy first. But for people at average risk of cancer (aka most people), a preferred option for meeting screening guidelines for colorectal cancer is a FIT test, or a stool-based screen. FIT tests can be completed at home, and can be much less daunting than colonoscopies.

For health leaders and HR benefits professionals, FIT tests offer a simple, extensive way to help bring employees up to guidelines. The American Cancer Society recommends people at average risk for colorectal cancer begin doing annual screenings with FIT tests at age 45. By making simple, at-home FIT tests readily available to their population, employers can get well ahead of the burdens (financial and otherwise) that can be posed by delayed screenings.

FIT tests offer a way to screen a large population in an affordable and accessible way. (You can imagine it’s much less intimidating to get a workforce to do an at-home screening than it is to get everyone to book and complete a bunch of colonoscopies). 

After that initial FIT screen, it is true that anyone who receives abnormal results should then follow up with a colonoscopy. The same journey is true of multi-cancer early detection tests (MCEDs)—a preliminary blood sample test only recommended for people 50 years or older. If you receive an abnormal result from one of those, suggesting colorectal cancer, you are still recommended to follow up with a colonoscopy. Results from MCEDs are not enough to diagnose someone with colorectal cancer.

With several methods for detecting colorectal cancer, health benefits leaders should consider a tiered strategy to cancer prevention. Well-established tests like the FIT test or FIT-DNA test can make screening for colorectal cancer more tolerable for people. From there, those who receive abnormal results must still have easy, frictionless access to a colonoscopy. Comprehensive screening programs, fleshed out with care advocates and easy-to-use software, can make colorectal cancer prevention (and colonoscopies!) feel less burdensome.