At-Home Cancer Tests: PSA, Colon & Cervical Screening Options

At-home cancer screening tests are becoming increasingly available, offering convenience and accessibility for individuals who may face barriers to traditional screenings. However, it’s crucial to understand the limitations of these tests and the importance of follow-up care with a medical professional. Currently, at-home tests are available for prostate, colorectal, and cervical cancers, though not all are approved by the U.S. Food and Drug Administration (FDA) for at-home use.

Prostate Cancer Screening at Home

Prostate cancer risk can be assessed using a prostate-specific antigen (PSA) test, now available as a finger-prick blood test for at-home use. Individuals collect a blood sample and mail it to a lab for analysis. These tests are recommended every two to three years starting around age 50, but are best suited for those at average risk – meaning no family history of prostate cancer or other risk factors. If you are unsure of your risk level, consulting with a doctor is advised. It’s important to note that PSA levels can be influenced by factors like age, medications, and an enlarged prostate, and elevated levels do not automatically indicate cancer. Results should always be reviewed with a healthcare provider.

At-home PSA tests can be purchased from companies such as LabCorp, Pinnacle BioLabs, and Quest. However, most of these tests have not received FDA approval for at-home use.

Colorectal Cancer Screening Options

Several at-home options exist for colorectal cancer screening, generally recommended to begin at age 45. These tests are designed for individuals at average risk; those with a family history of colorectal cancer or experiencing symptoms like blood in the stool or abdominal pain should undergo a colonoscopy. At-home tests typically involve mailing a self-collected stool sample, with varying collection processes depending on the test type.

gFOBT and FIT Tests

The guaiac-based fecal occult blood test (gFOBT) detects hidden blood in the stool, potentially indicating cancer or polyps. This test requires collecting samples from three separate bowel movements. The fecal immunochemical test (FIT) also looks for occult blood but is simpler, requiring only one sample and no dietary restrictions beforehand. Both gFOBT and FIT tests should be repeated annually, and any abnormal results require follow-up with a doctor.

mt-sDNA Tests

Multitarget stool DNA (mt-sDNA) tests, such as ColoGuard and Colosense, analyze stool samples for both hidden blood and changes in DNA or RNA. Unlike gFOBT and FIT, a prescription is needed for mt-sDNA tests. These tests are repeated every three years. While FDA-approved, Colosense has not yet been included in screening guidelines from the American Cancer Society or the U.S. Preventatives Services Task Force, which may affect insurance coverage.

Xavier Llor, MD, PhD, a gastroenterologist at Yale Medicine, highlights the convenience of at-home tests, stating that they “rule out a lot of people who don’t need that colonoscopy.” However, he also notes that colonoscopies allow doctors to not only detect but also remove precancerous polyps, a capability not offered by at-home tests.

Cervical Cancer Self-Collection

Traditionally, cervical cancer screening involves a Pap test or HPV test during a pelvic exam. However, the FDA has approved two at-home sample collection options: the Teal Wand and the Onclarity Self-Collection Kit. These tests screen for specific types of human papillomavirus (HPV), the virus responsible for nearly all cases of cervical cancer. The process involves self-collecting a vaginal swab, similar to how a doctor would perform the test.

These at-home tests are particularly beneficial for individuals who experience anxiety, pain, or discomfort during pelvic exams, or who face scheduling or transportation challenges. Ernest Hawk, MD, MPH, medical oncologist and head of the division of Cancer Prevention and Population Sciences at MD Anderson Cancer Center, notes that “The cervical self-swab is easily done by the individual.” However, individuals with a history of cervical cancer, abnormal test results, or other risk factors should not use these at-home tests. A doctor’s order is required to obtain either test, and they must be repeated every three years, more frequently than the five-year interval recommended for doctor-administered HPV testing.

Pros and Cons of At-Home Cancer Screening

At-home cancer screenings offer increased access and convenience, particularly for those with limited time or transportation. They also provide a greater sense of privacy for some individuals and require minimal preparation compared to in-office procedures. However, it’s essential to recognize the potential for false negatives and the need for follow-up testing if results are positive or inconclusive.

“It’s really important to think of cancer screening as a process,” says Dr. Hawk. “A positive screening doesn’t mean you have cancer, but it does mean that you need further evaluation.”

Ernest Hawk, MD, MPH, medical oncologist and head of the division of Cancer Prevention and Population Sciences at MD Anderson Cancer Center

at-home tests are a valuable tool for early cancer detection, but they should not be considered a replacement for regular check-ups and consultations with a healthcare professional. If you receive a positive or inconclusive result from an at-home screening, it is crucial to contact your doctor for further testing and evaluation.