Forty-five is a special age for healthcare, but not exactly a fun one. It's the age when screenings like colonoscopies and mammograms should begin. A colonoscopy “alternative" is piquing interest—one that requires no colon prep, no sedation, no stepping foot in a hospital. It’s called a stool DNA test which can be completed at home. How do gastroenterologists feel about them? Gastroenterologist Chad Gonzales weighs in with some recent data.
How do at-home stool tests work?
At-home colonoscopy tests detect early signs of colorectal cancer using a stool sample collected at home and mailed back to the lab. The sample is analyzed for small traces of blood or abnormal DNA that may be shed by cancer or precancerous polyps.
Research shows stool DNA screening can detect many colorectal cancers and some advanced polyps, but it is not perfect. A positive result still requires a follow-up colonoscopy, and the test must be repeated more frequently than colonoscopic screening. Because of these factors, medical experts continue to discuss where these tests fit within the broader landscape of colorectal cancer prevention.
Are at-home tests a helpful screening option, or a false sense of security?
Stool test pros: | Stool test cons: |
Convenient and noninvasive Encourages screening Detects multiple warning signs Covered by many insurance plans | Not as sensitive for precancerous polyps Positive results require a colonoscopy Must be repeated more often False positives & false negatives can occur |
Where at-home tests fit in, and where they fall short
“We have and continue to utilize at-home stool tests for some patients,” says Gastroenterologist Chad Gonzales. They reduce friction for average-risk patients who may not otherwise get tested, but have their flaws, as well. “In reviewing patient data from last year (2025), we found that about one in three patients did not complete a colonoscopy after receiving a positive at-home test,” he adds. "Those odds aren't good."
“Another flaw in these is that false positives tend to increase as patients get older, particularly between ages 65 and 84,” Dr. Gonzales explains. This can lead to unnecessary stress, additional testing, and confusion about next steps.
Who might an at-home stool test work well for?
At-home stool tests can be a reasonable option for patients at average risk—but only within a specific set of criteria:
- Ages 45 to 64
- No family history of colorectal cancer
- No prior adenomas (precancerous polyps)
- No history of inflammatory bowel disease (IBD)
“For average-risk patients, screening with either a colonoscopy or an at-home test can be appropriate,” says Dr. Gonzales. The key is choosing a screening method and completing it consistently.
For patients at elevated risk, colonoscopy is not just preferred, but recommended.
Dr. Gonzales advises colonoscopy for patients who have:
- A first-degree relative with colorectal cancer or advanced adenomas
- A personal history of adenomas
- Inflammatory bowel disease (IBD)
- Genetic conditions such as Lynch syndrome
- Symptoms like rectal bleeding, anemia, or unexplained weight loss
“These patients need a direct evaluation of the colon,” Dr. Gonzales says. Unlike stool-based tests, colonoscopy allows physicians to both detect and remove precancerous polyps during the same procedure, making it a powerful tool for prevention, not just detection.
A phrase adopted by Dr. Gonzales and the gastro team at Ogden Clinic is "The best colonoscopy screening is the one you're going to get." And for that, at-home stool tests do present benefits for early detection.
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Are you over age 45? It's time to schedule a colon cancer screening. If you live in Northern Utah, you can learn more or get started at colonoscopyutah.com.