Hate Going In for a Colonoscopy? These 6 Easy At-Home Colon Cancer Screening Tests Might Save You a Trip

Ah, the colonoscopy: A doctor sticking a tiny camera up one’s behind to look for cancer has got to be one of our society’s most awkward rites of passage into middle age. Uncomfortable? Prep certainly can be. Medically necessary? Well, actually, not always. Don’t get us wrong: Screening for colon cancer is incredibly important — it’s currently the second most frequent cause of death from cancer worldwide, and colonoscopies have typically been recommended beginning around age 45 to screen for colon cancer for people at average risk.

 However, many people aren’t aware of another option for those not at an increased risk of colon cancer — one that can be done at home, using a stool or blood sample, for less than the cost of a tank of gas.
“I often get raised eyebrows,” Thomas Imperiale, MD, gastroenterologist at the Indiana University School of Medicine in Indianapolis, told JAMA when recounting how his patients usually react when he tells them there’s an at-home colon cancer screening test option.

These at-home screenings are either guaiac fecal occult blood tests (gFOBT); FOBT with immunohistochemical testing (iFOBT); otherwise known as fecal immunohistochemical tests (FIT); or mt-sDNA tests. The first two types of tests screen for hidden blood in the stool, which is a common symptom of colon cancer. And the FIT isn’t exactly new. It was first developed in the late 1980s and has already become the standard test for colon cancer in the United Kingdom. And they’re fairly accurate too: At-home FITs can detect as little as 45 nanograms per mililiter (ng/mL) fecal hemoglobin concentrations. That’s why, when used on a proper timeline, stool tests can be about as effective as a colonoscopy in screening for colon cancer for many people, says Laura Makaroff, DO, the senior vice president of prevention and early detection at the American Cancer Society (ACS).

Cologuard is an mt-sDNA test. It looks for abnormal DNA as well as blood in the stool. None of these at-home tests are quite as sensitive as a singular colonoscopy, but colonoscopy screens are generally only recommended every 10 years.

Blood Tests

Other colon cancer screening tests currently under development are at-home blood sample tests. Their low level of accuracy means they are currently not recommended for use in place of FOBT, FIT, or mt-sDNA screening tools.

The three types of doctor-recommended tests are:

If any of these at-home options sound like something you’re interested in considering, we’re here to help you learn more so that you can, in consultation with your medical provider, figure out which one might be best for your needs. Here is what to know about the expert-recommended at-home options for each type of at-home colon cancer screening test.

When to Consult Your Doctor

It is always recommended that you consult with your medical provider to see if you are a good candidate for an at-home colon cancer screening test. If you are at higher risk due to factors like age, family history, or underlying conditions, colonoscopies are recommended.

A positive at-home FIT, Cologuard, or colon cancer blood test should always be followed up by a visit to a gastroenterologist. None of these tests is a replacement for a colonoscopy: they are a simple, noninvasive way to see if a colonoscopy is necessary.

Blood in the stool can be caused by several diseases besides colon cancer, including diverticulitis, hemorrhoids, inflammatory bowel disease, polyps, and ulcers. So while a positive FIT result does not mean you have cancer, it does mean you need to schedule a colonoscopy.

Lab-Tested FITs

With a lab-tested FIT, your kit will contain sample collection materials, a container, and an envelope to mail your sample to a lab, where it will be tested. Your results are usually retrievable through an online portal, or via email. Whether performed in a lab or at home, the FIT is the same test. The diagnostic performance of the test depends on its sensitivity, which is determined by its cut-off value. That means how much blood needs to be present in the sample to yield a positive test result.

 Some lab-tested FITs have a lower cut-off value than home tests, while others don’t: The LabCorp test below boasts a 20 ng/mL cut-off, while Simple Colon’s FIT, which is also lab-tested, uses a 45 ng/mL cut-off value, which is the same as several home-tests. A lower cut-off isn’t necessarily better. One observation study found that 45 ng/mL is the optimal FIT cut-off when screening for colon cancer specifically.

 However, if you’re not confident administering the test accurately yourself, using a professional lab is never a bad idea.

Here are the two lab-tested FITs that are available:

LabCorp On Demand colon cancer test

LabCorp On Demand ColoFIT Home Collection Test

Pros

  • HSA/FSA payment accepted
  • Available to anyone age 18 and over
  • Results available online
  • Purchase and testing process overseen by healthcare professionals
  • Results posted 3–4 days after sample received

Cons

  • Slightly higher cost
  • Must be done annually
  • Not specific to colon cancer
  • Only sold on LabCorp site

Key Specs

  • Type of sample: Stool
  • Type of test: FIT
  • Testing method: Mail-in lab analysis
  • Follow-up care: Not offered

The LabCorp On Demand ColoFIT test is a great option for anyone looking to screen at home without performing the actual test themselves. With this one, all you have to do is collect your stool sample and mail it to the lab, where a professional administers the FIT and posts the results online.

This adds a few days of suspense before getting your results but removes the potential for user error in administering the test yourself, making it a great option for anyone feeling unsure of the testing process. LabCorp will perform the test and post your results online in your personal account within three to four days of receiving the sample.

Your submission will be reviewed and approved by a healthcare professional. For results that require follow-up care, patients will be contacted by phone and email as well as through their online portal. So while there is no doctor’s visit involved, LabCorp’s service includes some support from actual healthcare providers.

Simple Colon Health Test

$59.96 at Amazon

Pros

  • FSA/HSA accepted
  • Free follow-up care for positive results
  • Affordably priced
  • Available for less at online retailers

Cons

  • Not available in New York
  • Must be done annually
  • Not specific to colon cancer

Key Specs

  • Type of sample: Stool
  • Type of test: FIT
  • Testing method: Mail-in lab analysis
  • Follow-up care: Available

Simple Healthkit is a California-based company that offers an at-home FIT with lab analysis. The company was founded by Sheena Menezes, PhD, and aims to make healthcare more accessible by offering integrated care. Its at-home test kits are intended as a starting point to get individuals the care they need.

The company prides itself on having a 100 percent outreach rate for people who receive positive test results. A member of their team is guaranteed to follow up with you to make sure you understand your results. Follow-up treatment is free in cases of a positive result; customers are encouraged to schedule a telehealth appointment through Simple HealthKit to discuss their results and next steps at no charge.

Users described the kit as easy-to-use and straightforward, with results posted online as soon as three days after mailing in the kit. However, the kits are not available in New York State.

In addition to Amazon and Walmart, you can also purchase this test on Simple Healthkit's website.

Home-Tested FITs

With a home-tested kit, you’ll receive one or more test cassettes along with the materials to collect your samples. The test is similar to a COVID test — except instead of swabbing mucus, you’ll be mixing a bit of your stool sample into a liquifying agent and using a dropper to put it onto the test cassette. As with a COVID test, two lines — however faint — mean a positive result, and one line means negative.

While lab-tested FITs only ever accommodate a single test, home-tested kits are often sold in multipacks. One study showed the accuracy of the FIT increases if you take it twice: Taking a second test, about two weeks after the first, increased the detection rate to 96.6 percent, up from 84.1 percent for just one test.

 Sometimes, a person may have an issue that is not actively bleeding while taking the first test, and testing twice helps catch it. If you’re capable of carrying out the test at home, you can test twice, actually increasing the FIT’s accuracy over a single lab-tested FIT.

Here are the two Home-Tested FIT Tests available:

Diagnox Colonox FIT

$12.97 at Amazon
$14.95Now 13% Off

Pros

  • Results in 10 minutes
  • Detects hemoglobin concentrations as low as 45 ng/ml
  • FDA-approved for home use
  • No need to mail in sample
  • Suitable for all ages

Cons

  • No support during testing or follow-up care
  • Home testing leaves room for user error
  • Sample collection paper is flimsy

Key Specs

  • Type of sample: Stool
  • Type of test: FIT
  • Testing method: Conducted at home
  • Follow-up care: Not offered

Diagnox offers a variety of at-home test kits for issues like urinary tract infections, kidney disease, and vaginal health. Its tests are designed and priced for repeat use, making this one of the most affordable options on the market. It’s available in multipacks of two or three as well as a single kit.

The test boasts one of the highest sensitivities on the market, detecting concentrations of blood in the stool as low as 45 ng/mL. Some lab-tested kits only detect as low as 100 ng/mL. Results appear in as little as 10 minutes. The kit is approved by the U.S. Food and Drug Administration (FDA).

However, some customers complained of the kit returning no result (no line turning up), while others found the sample collection paper to be too flimsy to properly collect a sample. Also, there’s no follow-up assistance from a healthcare professional.

Pinnacle Biolabs Second Generation FIT (2-pack)

$29.99 at Amazon

Pros

  • FSA/HSA eligible
  • Results in 5 minutes
  • High user ratings
  • Easy sample collection 

Cons

  • Home testing leaves room for error
  • Shipping can be slow

Key Specs

  • Type of sample: Stool
  • Type of test: FIT
  • Testing method: Conducted at home
  • Follow-up care: Not offered

The Second Generation FIT is made by Pinnacle BioLabs, an industry leader in at-home FIT. Its accuracy, price, and customer service are all solid, but what truly sets this kit apart is its extra-easy sample collection method.

While most other kits require users to poop on a piece of paper — with many complaints of the paper breaking, and the sample falling into the toilet below, which can lead to a contaminated sample and inaccurate results — this kit pulls the sample off a piece of used toilet paper. This leaves less room for contamination and more room for your dignity. It’s understandable why this has been the top-selling at-home FIT kit for the past four years running, with over 18 million kits sold.

Instant-View iFOB Test (2-pack)

$25.99 at Amazon

Pros

  • Over 99.5 percent accurate
  • Results in 1 minute
  • Easy sample collection
  • Suitable for all ages

Cons

  • Home testing leaves room for error

Key Specs

  • Type of sample: Stool
  • Type of test: FIT
  • Testing method: Mail-in lab analysis
  • Follow-up care: Not offered

Instant-View’s Immunochemical Fecal Occult Blood Test (iFOB, which is the same as an FIT) is made in California by Alfa Scientific Designs and uses a very small sample, allowing users to conveniently obtain their sample from a piece of used toilet paper.

The test cassette features a patented Driven Flow technology, which squeezes the sample drop up the cassette and through the reaction area at a higher speed than other kits. Not only does this allow you to read the sample results almost immediately — it also maximizes the reaction of the binding complexes. According to Alfa, this improves the accuracy of the result. Sadly, no follow-up care is offered.

Stool DNA FIT Test

The only hybrid DNA FIT test available in the United States right now comes from Cologuard. It runs the same FIT described above, but also tests the sample for abnormal DNA, which is another test completely separate from the FIT. Both tests are done in a lab, and your results are provided online — and as Cologuard requires a prescription, your healthcare provider will follow up with you in case of a positive result.

In addition to boosting the test’s detection rate to 92 percent, the DNA test offers an advantage over the FIT because it's cancer-specific. If it returns a positive FIT result, knowing whether or not the DNA test was also positive would mean a lot while waiting to book your colonoscopy.

The kit can be purchased out-of-pocket, but it costs about $650. However, most people eligible for Cologuard are also eligible for insurance coverage via Medicare or Medicaid; most users pay nothing.

Cologuard logo

Exact Sciences Cologuard Kit

Pros

  • Specifically tests for colon cancer
  • Detects 92 percent of colon cancers
  • Only needs to be administered every 3 years
  • Support from healthcare professionals
  • Free with Medicare, Medicaid, and most insurance

Cons

  • Requires a prescription
  • Not available to anyone under age 45

Key Specs

  • Type of sample: Stool
  • Type of test: FIT and abnormal DNA
  • Testing method: Mail-in lab analysis
  • Follow-up care: Available

Like FIT, Cologuard is a stool sample–based test, but in addition to blood, it also tests the stool sample for abnormal DNA caused by cancer, making it even more sensitive than the FIT. Cologuard is only for people ages 45 to 75 with no symptoms and no family history of colon cancer. If you do fall into this group, Cologuard is likely a great option for you.

The kit, manufactured by Exact Sciences, is covered by most forms of insurance, and 96 percent of patients receive it completely free. You will need a doctor’s prescription, but Cologuard can help you with this part, too. The Cologuard website will send you over to Recuro Health, its telehealth partner, to get a doctor’s approval if you appear to be eligible after the online survey.

The test even just got an update — increasing the sensitivity from 92 to 95 percent, meaning better detection for both cancer and precancerous polyps.

A Note About Blood Sample At-Home Colon Cancer Tests

Several at-home cancer screening tests that use blood samples are also available. These multicancer early detection (MCED) tests are created to detect many different cancers, including colon cancer. Blood sample tests look for proteins excreted by cancerous tumors as they grow, known as biomarkers. Many different cancers produce the same biomarkers, making these tests an effective tool for testing for a large number of cancers — including colon cancer — from a single blood draw. If it sounds too good to be true, it might be. MCED tests have a significantly lower sensitivity in detecting colon cancer than the FIT.

These types of tests are still being developed, and are currently not recommended for use in place of any standard single-cancer screening tool. One early study concluded they could be a useful diagnostic tool when used as a complement to single-cancer screening tests, such as the FIT, though.

Two available blood sample tests:

  • OneTest at-home cancer screening costs $200 and looks for seven cancer biomarkers. The sensitivity of the test is 76.9 percent for colon cancer, with an overall sensitivity of 87 percent in testing for the most common cancers, including liver, lung, prostate, pancreas, and colon.
  • Galleri, a once hotly anticipated MCED from GRAIL labs, costs $950, has had somewhat disappointing results, and has not received the FDA approval it was hoping to get. Its sensitivity in detecting colon cancer is 66.3 percent, while its overall sensitivity in detecting cancer is 51.5 percent, looking at all types of cancer across all stages.

A blood test specifically for colon cancer was recently released, but it is not available for home use, nor is it proven to be any more effective than at-home stool screening tests such as the FIT.

Comparison Table

Type of Test
Type of Sample
Cost
Available in Multipack
FIT Cut-Off Value
Lab-tested FIT
Stool
$60
No
45 ng/mL
Home-tested FIT
Stool
$15
Yes
45 ng/mL
Home-tested FIT
Micro-stool (taken from used toilet paper)
$30
Yes
50 ng/mL
Home-tested FIT
Micro-stool (taken from used toilet paper)
$30
Yes
50 ng/mL
Combined lab-tested FIT and lab-tested DNA
Stool
$650 or free with insurance
No
100 ng/mL

What to Look for When Buying At-Home Colon-Cancer Tests

If you’re considering an at-home colon cancer test, there are several important things to take into account. The first is whether an at-home test is a good option for you. Here are some other considerations.

Are You a Good Candidate for an At-Home Colon Cancer Test?

At-home colon cancer tests are considered a good option for people at a normal risk of colon cancer. If you have existing GI tract issues that cause internal bleeding, a family history of colon cancer, or symptoms of colon cancer, an at-home test is not the best option for you. As John Park, MD, at the Lehigh Valley Health Network in Allentown, Pennsylvania, explains: “Colonoscopy is the gold standard for colorectal cancer screening. If you are interested in at-home testing, your doctor can help you determine if you are eligible and make sure you understand all of the pros and cons.”

Should You Test at Home or Mail Your Sample to a Lab?

While the FIT cassette available to use at home is the same test as the one used in the lab, mailing your sample in for testing reduces the risk of user error. Of the negative reviews of online tests, many users complain they could not obtain a result (zero lines) from their cassette. The tests work much like a home COVID-19 or home pregnancy test; if you’re not comfortable with those, choosing a service that mails your sample to a lab might be a better option for you.

Are You Eligible for Cologuard?

If you are between ages 45 to 75, insured, and at normal risk for colon cancer, Cologuard is the standout option. It has all the benefits of an at-home FIT, with the added benefit of abnormal DNA testing, and it’s completely covered by most insurance.

What’s the Difference Between an At-Home Colon Cancer Test and a Colonoscopy?

A colonoscopy has many medical advantages over an at-home test. For example, if a polyp is found during a colonoscopy, it can be removed right then. Also, while an FIT only detects the presence or absence of blood, a colonoscopy can determine the source of the blood, whether it be from an ulcer, hemorrhoid, polyp, or cancer. Any positive FIT should be followed up with a colonoscopy. Still, an FIT is a great way to reduce the number of people who need colonoscopies — hopefully including you. Many people who undergo colonoscopy to screen for colon cancer simply aren’t aware that FIT is generally a suitable alternative.

How Accurate Are At-Home Colon Cancer Tests?

Compared with a colonoscopy, which is about 99 percent accurate at detecting a cancer that has developed, the Cologuard DNA-based test has an accuracy of about 92 percent at detecting cancer. The FIT has an accuracy of about 80 percent, but this is not testing for cancer, but for the presence of blood, which could result from several different diseases.

What to Do if Your At-Home Colon Cancer Test Is Positive

First of all, don’t panic! False positives are relatively common with these tests. If you used an FIT, remember, a positive result just shows you may have blood in your stool — it is not a positive result for cancer. You will need to schedule a colonoscopy with your doctor to get a conclusive result, though. Some tests listed here offer follow-up care. If you’d like help following up in the event of a positive result, we suggest using a test that offers this type of support. Otherwise, consult with your PCP to book a colonoscopy as soon as possible. 

At What Age Should I Start Using an At-Home Colon Cancer Test?

The Centers for Diseases Control and Prevention (CDC) recommends beginning testing for colon cancer at age 45. Some screens — like Cologuard or a colonoscopy — are not covered by insurance for people under this age. However, in recent years, more and more cases of colorectal cancer are being found in young adults and even children and teens, and recommendations for screening younger age groups are increasing. One study showed that FIT-positive individuals age 30 to 49 had a higher rate of cancerous or precancerous growths than average-risk adults over 50. The study concluded that individuals over age 35 would benefit from FIT screening. For groups younger than 35, more studies are needed to determine whether at-home testing for colon cancer is recommended for the general public.

FAQs

Do I need a prescription for an at-home colon cancer test?
No. FIT, the most commonly offered type of at-home colon cancer test, is available over the counter and can be purchased online from retailers like Amazon and Wal-Mart.
You should expect to pay $20 to $30 for a two-pack of FITs if you choose to test at home. A one-pack kit with a lab-tested mail-in sample will cost about $60 to $90. 
No. Unlike preparing for a colonoscopy, there is no special preparation needed before taking an FIT.

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Mary Dennis

Author

Mary Dennis is a Singaporean American health and science writer based in New York. Her work has been published in the Beijinger, Nautilus, South China Morning Post, Motherly, and Verywell Mind.

Her interest in covering mental health increased after the pandemic revealed our society's increasing need for care and information about how to manage our emotional health. She is passionate about maternal mental health issues in particular, and is the founder of Postpartum Brain, a website designed to educate and encourage people to learn more about perinatal mental health issues.

Mary has a masters degree in science journalism from Columbia University.

Rabia de Latour, MD

Medical Reviewer
Rabia de Latour, MD, is a therapeutic endoscopist and gastroenterologist at NYU Grossman School of Medicine, where she serves as the director of endoscopy and chief sustainability officer at Bellevue Hospital. She is the host of Sirius XM Doctor Radio Internal Medicine Show.

Orlando de Guzman

Fact-Checker

Orlando de Guzman is a writer and editor with expertise in health and environmental news. He has a background in investigative and science journalism and has worked on documentary films about war and trauma, health, sanitation, and the changing climate around the world. His interest in health and medicine started after an early career as a medical and legal translator.

De Guzman is a longtime health and fitness enthusiast who is interested in nutrition, diet, and mental health. He participates in endurance sports and cross-trains in several traditions of martial arts from Southeast Asia. De Guzman is interested in how the progressively complex movements of martial arts training can improve cognition and mental well-being, especially for those with PTSD and for those approaching middle age and beyond.

De Guzman has a dual B.A. in communications and international studies from the University of Washington in Seattle. He is committed to factual storytelling and evidence-based reporting on critical choices that affect our planet.

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Olivia Campbell is the New York Times bestselling author of Women in White Coats: How the First Women Doctors Changed the World of Medicine and Sisters in Science: How Four Women Physicists Escaped Nazi Germany and Made Scientific History. She is a freelance editor at Dotdash Meredith and a freelance journalist. Her work has appeared in The Atlantic, National Geographic, New York Magazine, Health, Parents, History, and The Guardian, among other outlets.

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Resources
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