When colorectal cancer is detected early, illness and even death may be prevented. Yet it is the nation’s second leading cancer killer of both women and men in the U.S. For this reason, the Department of Health and Human Services has made March Colorectal Cancer Awareness Month in order to boost public awareness about the importance of screening for cancers of the colon and the rectum.

Why get a test?

Later he would say the signs were difficult to notice, though at the time he didn’t consider himself as having any symptoms. A little bit of pain on occasion when in the bathroom. Sometimes his stool appeared to have black streaks running through it. Only once did he notice blood, red and vivid, on the surface of his feces. Later, while visiting his doctor, he mentioned the blood. After asking whether this happened frequently, his doctor frowned. “Probably hemorrhoids. But you just turned 50. Have you had a colonoscopy?” She sighed as she completed the paperwork for him to visit a gastroenterologist. “It’s time to get tested anyway.”

The prep was difficult: an evening spent in the bathroom and then bedtime and a night’s sleep on an empty stomach. Arriving for the colonoscopy, he felt nervous about the test, though not the results; hemorrhoids, his doctor had said. What else could it be? He felt fine. The anaesthesiologist said, “Count backward from 100,” and after counting as far as 98, the next thing he remembered was waking up. His dream of a beautiful forest was vivid and lush. Seeing him stir, the nurse left the room and returned with the doctor whose pained expression told him everything.

“We found a tumor.”

Each year, about 137,000 adults are diagnosed with colorectal cancer, while in 2010 alone, over 52,000 Americans died from it. Sometimes called bowel cancer, colorectal cancer refers to any cancer that forms in the tissue of the longest part of the large intestine or the rectum — the last several inches of the large intestine closest to the anus. In particular, colon cancer is known as the "symptomless cancer" because often there are no signs other than occasional pain and blood in the stool, which may not be colored red as expected but black (this happens when the bleeding is higher up in the colon). People over the age of 50 are at the greatest risk of colorectal cancer and this is why the United States Preventive Services Task Force (USPSTF) recommends that all individuals between 50 and 75 be screened for colorectal cancer as part of their routine preventive health care.

Currently, about one in three adults within that age range are not receiving recommended screening. These are most likely to be people who don’t live in a city; men; people with lower education and income; Hispanics; American Indian or Alaska natives; and people under 64. Colorectal cancer and death from this disease can be prevented thanks to effective screening tools.  There are three tests — colonoscopy; stool tests (either the fecal occult blood test or fecal immunochemical test); and flexible sigmoidoscopy — and all are effective at finding cancer early. Under the Affordable Care Act, there is no cost for taking any one of these tests for people who purchase health insurance from one of the state exchanges.

Naturally, many people wonder: Which is the best test?

The best test is the test that gets done!