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There are four different ways to be screened for colon cancer. Read on to find out which test might be a good choice for you.

So you鈥檝e reached a birthday milestone 鈥� and surprise! 鈥� it鈥檚 time to begin screening for colon cancer. If the thought of colon cancer screening makes you shudder, you鈥檙e likely not alone: About of eligible American adults haven鈥檛 been screened. Since colon cancer is the in the country (and the third most-diagnosed), this is a serious problem.

Add to this the fact that from the American Cancer Society have lowered the age at which people should start getting screened for colon cancer, if they are at average risk. Now it鈥檚 recommended that people begin screening at age 45 (previously, the recommended age was 50).

It turns out there鈥檚 good reason the guidelines recommend screening at a younger age.

鈥淲e know from our experience as health care providers 鈥� and there is plenty of emerging evidence to support this 鈥� that people are being diagnosed with colorectal cancers at an increasingly young age,鈥� says Christine Hsieh, MD, a colorectal surgeon with 喵咪社区.

So, before you think of skipping screening altogether, familiarize yourself with the , and talk to your doctor about which one makes the most sense for you.

1. Stool test

This test looks for blood and/or in your stool that may indicate cancer. For this test, you鈥檒l get a kit with instructions on how to take a sample. The test is easy to do at home and must be done every year. (The DNA test may be done once every three years.)

鈥淚f you opt to have a stool test, you should be aware of the diet restrictions that need to be followed before the test; otherwise, you might have a false positive,鈥� Dr. Hsieh advises.

If anything is found in your stool test, you鈥檒l need to have a colonoscopy.

2. Colonoscopy

A colonoscopy is a procedure done under sedation, which means you鈥檒l need someone to take you to your appointment and stay with you afterward. The night before, you鈥檒l have to drink liquids, take a pill and/or use an enema to completely empty your bowels. During the procedure, the doctor will look at your entire colon and remove any potentially precancerous polyps. Since colonoscopies are very thorough, they need to be done only once every 10 years.

3. Virtual colonoscopy

Known as CT colonography, this is a specialized CT test that requires a full bowel prep but does not require sedation. During the test, air is injected into your colon to push the walls of the colon apart, before a CT scan is done.

鈥淰irtual colonoscopy is best for detecting polyps that are larger than 5 millimeters, but sometimes errant pieces of stool can cause a false positive,鈥� Dr. Hsieh says.

If anything is found during this test, you鈥檒l need a follow-up colonoscopy.

4. Flexible sigmoidoscopy

This test is similar to a colonoscopy but only examines the lower third of the colon. It requires a bowel prep (often with a laxative and an enema) and typically isn鈥檛 done under sedation. Flexible sigmoidoscopy needs to be repeated every five years (or every 10 years, if it鈥檚 combined with an annual stool test). If anything is found during a sigmoidoscopy, a follow-up colonoscopy will be required.

So, which test is best?

There鈥檚 no test that鈥檚 best for everyone; however, some doctors consider colonoscopy to be the gold standard for screening, because it can look at the entire colon.

鈥淐olorectal surgeons tend to favor full colonoscopy, as it鈥檚 both diagnostic and therapeutic,鈥� Dr. Hsieh says.

Also, if anything abnormal is found with a stool test, virtual colonoscopy or flexible sigmoidoscopy, a colonoscopy will be required, which will mean some people will need to have two tests, Dr. Hsieh adds.

Each test has pros and cons, so be sure to discuss them with your doctor. Ultimately, the decision is yours, but your best bet may be to pick the test you鈥檙e most likely to actually get done.

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