Prostate Exam vs Colonoscopy: What’s The Difference?

Prostate cancer is the most frequent form of cancer in American men and the 2nd major cause of mortality. 

Colorectal cancer is the 3rd most common invasive cancer in the U.S. 

Both ailments are known to have a profound impact on man’s physical and mental health. 

Screening tools, like colonoscopies and prostate exams, can give men a fighting chance. 

These options are a valuable component of preventive medicine. They might help spot the abnormal tissue in its early stage and increase the odds of successful treatment.  

Because both a prostate examination and colonoscopy involve the backsides, many patients see them as similar procedures. 

But, these screening tests are nothing alike. They feel different, focus on separate areas of the body, and can be used for a wide range of purposes.

Here, you can take a look at the similarities and differences between a prostate exam vs colonoscopy. We will start with the basics, like they both are and then move on to the benefits and risks of each screening test. 

What is a prostate exam?

A prostate exam procedure is the gold standard for checking the prostate. 

Since the prostate is an organ situated inside the body, the doctor can’t see it directly. But they can feel it by placing a lubricated, gloved finger into the backside. 

The prostate exam checks for the prostate gland’s size, texture, and consistency. Any abnormality could indicate a problem with the prostate and may require further testing. 

A prostate examination can check for early signs of cancer, prostatitis, or benign prostatic hyperplasia. 

Now that you know what a prostate exam is, let’s take a closer look at colonoscopy. 

What is a colonoscopy?

A colonoscopy examination is a procedure that checks inside your bowels. 

The doctor uses a flexible, long, and tubular instrument that’s about ½ inches in diameter. The colonoscope goes through the rectum and comes out to the other end of the large intestine. 

The tube is equipped with a camera capable of transmitting images of the lining of the colon. Your doctor can use this image to examine the inside of the large intestine for any abnormalities. These include cancer, polyps, and irritated or swollen tissues in the rectum and colon. 

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Differences between prostate exam vs colonoscopy

Prostate exams and colonoscopies can be useful screening methods for finding cancer. But, because they are completely different procedures, it is important to take a look at the differences between a prostate exam vs colonoscopy. The information below can help.

Screening area

One of the main differences between a prostate exam vs colonoscopy is the screening area. A colonoscopy examines the inside of the colon, whereas a prostate exam focuses on the walnut-sized gland between the penis and the bladder. 

The colon is a tube-like organ and the longest component of the large intestine. It is roughly 5 feet long and much wider than the small intestines. 

It is located in the lower abdominal cavity, just below the stomach. This organ is a key component of the digestive system. 

The prostate is about 2 inches inside the rectum. With age, the size of the prostate gland tends to increase. This small gland is just under the bladder and is easy to reach with a lubricated finger. 


Colonoscopy is done to investigate any signs of intestinal problems. This includes chronic diarrhea, severe pain in the abdomen, rectal bleeding, etc. 

Patients can also use colonoscopy examination to screen for colon cancer or polyps. At times, colonoscopy can be used to treat a problem and remove polyps.

A prostate exam can only be used to detect swelling of the prostate, prostate inflammation, and prostate cancer. You can’t use it to treat an issue. 

Methods used

In order to understand the differences between a prostate exam vs colonoscopy, it’s important to take a look at how is a prostate exam done. 

For a prostate exam, the urologist uses a gloved finger to examine the back wall of the prostate. Patients lie on their sides or bend forward to allow the doctor to examine the prostate. The procedure usually takes about a minute.

During a male prostate exam, patients feel a slight pressure and momentary discomfort. You may feel like you need to urinate. 

If too much pressure is applied to the prostate, semen can be released. But, the test doesn’t cause any major damage or pain to the prostate. 

A colonoscopy is different. Patients lie on a table while a doctor inserts a colonoscope through the rectum. 

The device releases up to 17 liters of air into the large intestine. This inflates the colon, giving doctors a better view of the lining. The testing can take anywhere from 30 to 45 minutes.

The colonoscopy is typically done under anesthesia, so you don’t feel anything. If you receive light sedation, then you could feel discomfort. 

After the procedure, you may feel bloated or have abdominal discomfort. These symptoms should subside in the next 24 hours. 


Another difference between a prostate exam vs colonoscopy is how you prepare for testing. 

Before a colonoscopy, you will need to clean and empty your colon. Patients have to fast and use quality laxatives. 

Three days before the exam, you can eat low-fiber foods. You should avoid consuming products that contain any blue, purple, or red dyes. 

This type of food coloring can interfere with the test results. At this time, you won’t be taking any anti-diarrheal meds or fiber supplements.

If you are using any meds for heart problems or diabetes, consult with a specialist. You might need to adjust the medication. 

Two days before a colonoscopy, you can keep consuming low-fiber foods. But, a day before, you are expected to focus only on a clear liquid diet.

You will consume laxatives but can’t eat any solid foods. This can help cleanse the colon and prepare it for the exam. 

To avoid dehydration due to laxatives, it is crucial to drink a minimum of 8 glasses of liquid daily. During this period, you shouldn’t consume any substances, marijuana, or alcohol. 

Prostate exams, on the other hand, require little preparation. Take a shower before testing, and let your doctor know if you have any skin tears around the anus, hemorrhoids, or other problems with the rectum. Doctors may suggest you refrain from sexual activity for 48 hours before testing. 

Ejaculating can cause a temporary spike in PSA levels. This could interfere with the results. 


Many people question if a prostate exam is the same as a colonoscopy, but the answer is no. These are completely different testing methods, but they share some similarities. 

Prostate exams and colonoscopies have two things in common – they both involve the bottom and can be used to detect cancer. 

During a prostate exam procedure, the doctor places a finger inside the buttocks to feel the bulge behind the rectum wall. They then massage the lining and check the evenness of the surface. 

Anything that feels irregular, such as the presence of pain, nodules, or a hard surface, can indicate a prostate problem.

A colonoscopy uses a tube to check the colon. The tube goes inside the rectum until it reaches the colon. 

The colonoscope can use a water jet to clean the colon lining, use suction to get rid of any liquid stool, or inject air to inflate the colon. This tube makes it easy to see inside the organ. 

Benefits of prostate exam vs colonoscopy

A prostate exam can help spot any early signs of prostate cancer. It can also be a practical approach for checking the health of the prostate. The procedure is much shorter than a colonoscopy and doesn’t require any form of anesthesia. 

A colonoscopy examines the entire inside of the colon. It does take longer to complete, and patients often do need anesthesia. But this is the kind of procedure you can turn to when you need a biopsy to remove polyps or check the colon for any serious abnormalities. 

When you take a look at the benefits of colonoscopy vs prostate exam, you should know that prostate examination can only prove useful for men. In contrast, both women and men can get colon cancer. This makes colonoscopy a versatile procedure. 

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Risks of prostate exam vs colonoscopy

To get a better overview of the differences between prostate exam vs colonoscopy, you should also consider the risks. 

Colonoscopy is a more complex procedure than a prostate examination. It can come with more risks. 

Some patients might experience bleeding from their rectum after a colonoscopy. Other risks include belly discomfort, pain, reaction to anesthesia, and infection. 

If the doctor has to remove a polyp, they have to use tools to seal the area. Although it rarely happens, it is possible for the current to reach deeper and inflame or burn the tissues. This could trigger quickened heart rate, fever, and stomachache. 

Some patients may experience small tears that require surgery. With prostate exams, patients shouldn’t develop any side effects. You may faint if you experience emotional distress. But this is purely a vasovagal response. 

Which is better?

It depends on the type of problem you have. 

Prostate exams are best used when you experience problems with the prostate. This includes painful urination, dribbling, painful ejaculation, etc. A colonoscopy is better if you have colon problems. For example, a constant change in bowel movements, rectal bleeding, cramping, etc.

Do you get a prostate exam during a colonoscopy? 

A colonoscopy can provide a great opportunity for doctors to use a digital rectal exam to look for prostate cancer. Urologists can focus on the prostate while doing a digital rectal exam before a colonoscopy. That’s because you can’t get a prostate exam during a colonoscopy – they are done separately.


There are plenty of differences between a prostate exam vs colonoscopy. To understand both of them, you need to know how to do a prostate exam versus a colonoscopy. Both options involve the buttocks but are used to examine different areas of the body.

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  1. Jain MA, Leslie SW, Sapra A. Prostate Cancer Screening. [Updated 2022 Nov 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.
  2. Hammett T, Hookey LC, Kawakami J. Do patients undergo prostate examination while having a colonoscopy? Can J Gastroenterol. 2009.

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