How to Get Screened for Colorectal Cancer

Screening can save your life. There are many tests that can help detect colon cancer, including colonoscopy, fecal occult blood testing (FOBT), fecal immunochemical testing (FIT), and stool DNA testing (Cologuard®).1

Talk to your doctor about the test that's right for you.

Description of Test
  • Long, thin, flexible, lighted tube inserted in the rectum2
  • Examines rectum and entire colon to check for polyps and some cancers2
Fecal occult blood testing (FOBT)
  • A home test used to check for any hidden blood in stool2,3
Fecal immunochemical testing (FIT)
  • A home test used to check for hidden human blood in stool2,3
Stool DNA test (Cologuard®)
  • Tests for both DNA changes and blood in stool3
  • May also be known as an FIT-DNA test1
How Often Is This Test Recommended?
  • Once every 10 years2
Fecal occult blood testing (FOBT)
  • Once every year3
Fecal immunochemical testing (FIT)
  • Once every year2
Stool DNA test (Cologuard®)
  • Every 3 years3
Procedure Information
  • Usually requires a special diet and laxatives before the test3
  • During the test, medication will keep you comfortable and sleepy3
  • If a polyp is found, it can be removed and tested3
Fecal occult blood testing (FOBT)
  • FOBT may require collection of up to 3 stool samples3
  • You may need to follow a certain diet before the test since some foods or drugs can affect the results3
  • Usually completed at home2
Fecal immunochemical testing (FIT)
  • Like the FOBT, FIT can usually be done at home2
  • No special diet required for FIT3
Stool DNA test (Cologuard®)
  • No special diet required for Cologuard4
  • Sample will be tested in about 2 weeks4
  • If the test is positive (if it finds DNA changes or blood), a colonoscopy will be needed3

Colorectal Cancer Screening Coverage

With the passing of the federal Affordable Care Act (ACA) in 2010, nearly everyone has been ensured no-cost coverage for many screening exams as recommended by medical guidelines, including those for colorectal cancer.5

At the current time, the ACA states that no-cost screening for colorectal cancer is required for anyone between the ages of 50 and 75.5,6 This coverage includes colonoscopy, sigmoidoscopy, and FOBT.5 However, the ACS recommends screening start at age 45, and some insurers are likely to cover screening, but are not yet required to do so.5 Therefore, individuals following the recommended screening guidelines (eg, between the ages of 50 and 75 and at the recommended testing frequency) should not have any out-of-pocket costs for these screening tests.

However, legislation may change and/or there may be some situations in which the ACA legislation may not apply, so talk to your insurance company about these possible exceptions prior to scheduling medical screenings.

BE PREPARED with questions to help guide the conversation.

Knowing the Difference Between “Preventive” vs “Diagnostic” Tests

Most insurance plans classify colorectal cancer screening as a preventive health care service and, therefore, cover the cost of the screening. So, for example, if your doctor decides that you should be screened based on your age (between the ages of 45 and 75) or family history, that screening would be considered a preventive screening.

In this same situation, if polyps are found and removed during a colonoscopy, this procedure may still be considered preventive under most insurance plans. However, if a polyp is sent to a lab for testing, the testing itself will be considered diagnostic because the lab results will need to be reviewed to determine if the polyp is cancerous.7 Therefore, the patient may be required to pay an out-of-pocket expense (co-pay, deductible, coinsurance).7

Additionally, a deductible may need to be paid if the colonoscopy is prescribed to diagnose an unknown health problem, like if a patient is experiencing symptoms such as bleeding or irregularity.7 In this circumstance, the procedure would be considered diagnostic.7

Take a look at the Preventive vs Diagnostic Fact Sheet to help understand the difference in health care coverage for preventive and diagnostic services.

Talk with your doctor and insurance company before being screened to understand which types of services will be covered under your plan and what out-of-pocket costs to expect.


  1. Colorectal cancer: screening. US Preventive Services Task Force website. Accessed March 25, 2020.
  2. Colorectal cancer screening tests. Centers for Disease Control and Prevention website. Accessed March 25, 2020.
  3. Colorectal cancer screening tests. American Cancer Society website. Accessed March 25, 2020.
  4. The Cologuard® experience: Risk info. Accessed March 23, 2020.
  5. Insurance coverage for colorectal cancer screening. American Cancer Society website. Accessed March 25, 2020.
  6. Wolf AM, Fontham ET, Church TR, et al. Colorectal cancer screening for average-risk adults: 2018 guideline update from the American Cancer Society. CA Cancer J Clin. 2018;68(4):250-281.
  7. Preventive vs. diagnostic care. Healthy Times. Blue Cross Blue Shield of Massachusetts website. Accessed March 25, 2020.