Colorectal health: member guide
Your colon is the same thing as your large intestine, an essential (and busy) part of your digestive system. The colon processes food not digested by the small intestine. It absorbs water and minerals and forms and stores feces. A healthy colon is part of our overall health and well-being.
Colorectal cancer is a disease in which abnormal cells grow in the colon or rectum, often beginning as polyps—or growths—that can become cancerous over time.1 Depending on where the tumor forms, colorectal cancer is either classified as colon cancer (in the upper part of the colon) or rectal cancer (in the lower part of the colon). If untreated, the cancer may spread to other parts of the body.
For most people, one of the most powerful tools in preventing colorectal cancer is regular screenings starting at age 45. Sometimes there are no symptoms present—which is why it’s important to follow screening guidelines. With regular screenings, polyps can be found and removed before they have the chance to become cancerous. The U.S. Preventive Services Task Force recommends that adults aged 45 to 752 be screened for colorectal cancer. (For those age 75+, ask your doctor if you should be screened.) If you have a personal or family history of colorectal cancer or polyps, your doctor could recommend screenings before age 45.
A colorectal screening test is part of preventive care, done to prevent health issues or detect problems early, before symptoms are present. Your copay for a preventive screening is $0 when seen by an in-network provider.
To find in-network providers and costs, search “colon cancer screening” in the Surest app or website.
What symptoms should I watch for?
See a doctor if you have symptoms. Watch for:
- Changes in bowel habits like frequent diarrhea, constipation, or narrowing of stools that last for more than a few days
- Rectal bleeding (you see blood in your stool), either bright red or dark brown/black
- Feeling that your bowels don’t empty all the way, even after you go to the bathroom
- Abdominal pain or cramping that doesn’t go away
- Unexplained weight loss when you haven’t been trying to lose weight
If you have symptoms or health issues that lead to colorectal testing, the test is not a screening for preventive care. Instead, this screening is called a diagnostic screening. That means the doctor will use the test to help monitor or diagnose a condition. There may be a copay for the diagnostic test, and the cost varies depending on where that test is performed. You can find your costs in the Surest app or website, by searching the name of the test, and choosing the “non-screening” option. For additional questions, call Member Services at the number on the back of your Surest member ID card.
Talk to your doctor about whether your colorectal testing is classified as screening or diagnostic before you schedule the test so you can understand your coverage. You might ask your doctor: “To help me schedule this test, I need to understand how the colonoscopy will be billed. Is the colonoscopy considered screening or diagnostic?” If your doctor tells you the colonoscopy is diagnostic, check the Surest app for your cost at different locations. Let your doctor know at which location you would like to have the test done.
Types of colorectal testing
There are two primary types of tests: At-home stool tests and tests that require a visit to a doctor’s office, clinic, or hospital. Tests differ in frequency, accuracy, preparation, discomfort, and risks.
Stool-based tests
Because these tests can be done at home, many people find they’re more convenient than a colonoscopy.
- • Fecal immunochemical test (FIT): Checks for signs of blood in the stool, recommended annually. The test kit contains instructions on how to collect stool samples. Does not include drug and dietary restrictions.
- • Guaiac-based fecal occult blood test (gFOBT): Checks for signs of blood in the stool, recommended annually. The test kit contains what you need for collecting small samples of stool. Includes direction about foods to avoid in the days before the test.
- • Combined fecal immunochemical test and stool DNA (FIT-DNA). Checks stool for blood and genetic changes in DNA that could indicate cancer, recommended every one to three years. The test kit has a container for collecting an entire stool sample. If the test result is positive, a colonoscopy will need to be done.
Colonoscopy
According to the Colorectal Cancer Alliance, a colonoscopy is the most effective screening exam.3 For this test, a doctor checks for suspicious-looking polyps or cancer inside the length of the rectum and colon. Full bowel prep is needed before the procedure. Guidelines suggest screening for average-risk individuals starting at age 45, performed every 10 years (or more frequently if the test is abnormal).
CT colonography (virtual colonoscopy)
CT colonography is an advanced type of computed tomography (CT) scan and X-rays that can show polyps or cancer. Unlike a colonoscopy, it doesn’t require sedation or a scope. Like a colonoscopy, it still requires prep. This test is typically done every five years.
Screening sigmoidoscopy
A screening sigmoidoscopy is like a colonoscopy, only doesn’t examine the entire colon. Instead, a long, thin, flexible, lighted tube is used to check for polyps or cancer inside the rectum and the lower colon (sigmoid colon). This is usually done every five years (unless you have an increased risk for cancer, in which case it may be performed more frequently).
How do I know which screening to choose?
There isn’t a one-size-fits-all test. Talk to your doctor about options. Considerations include:
- Your risk level, including medical conditions you may have
- Your preferences, including how likely you will be to complete the test
- How often you will need the screening test
A Colorectal Cancer Screening decision support tool can help you decide which test might be right for you.
What if a stool test screening is positive?
If a stool test is positive, be sure to follow up with your doctor. You’ll need to schedule a colonoscopy. A follow-up colonoscopy due to a positive stool test is considered a “screening colonoscopy” and will not have a copay. False positives can happen with stool tests and can be caused by the presence of blood in your digestive tract. Follow-up is very important.
If polyps are found during a screening colonoscopy, future colonoscopies may be considered diagnostic or non-screening, and the frequency of the tests will increase.
Other ways to help keep your colon healthy
In addition to following screening guidelines, the American Cancer Society also recommends taking these steps to help reduce your risk of colorectal cancer:
- Drink water
- Eat vegetables, fruits, and whole grains (high-fiber diet)
- Limit red and processed meats
- Get moving
- Maintain a healthy weight
- Don't smoke (if you smoke, quit)
- Limit alcohol intake (or don’t drink at all)
Resources
- Search the Health Library for more information
- Call Surest Member Services at the number on your Surest member ID card
Find more care options when you search “colorectal care”
© 2016 - 2025 Healthwise, Incorporated. This information does not replace the advice of a doctor.
This content is not medical advice. You should always consult with your health care professional.
1National Cancer Institute, 2025. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/colorectal-cancer
2 “Screening for Colorectal Cancer,” U.S. Centers for Disease Control and Prevention, 2025. https://www.cdc.gov/colorectal-cancer/screening/index.html
3 “At-home screening,” Colorectal Cancer Alliance, accessed 2025. https://colorectalcancer.org/screening-prevention/screening-methods/home-screening