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A colonoscopy is about as exciting as a trip to the dentist or DMV — OK, maybe even less exciting.

But for those at average risk of colon cancer, there’s an easier, less invasive way to screen for the disease from home. Fecal immunochemical tests (FITs) are a good option for those:

  • without lower gastrointestinal (GI) symptoms, as can come from hemorrhoids
  • without a history of colon cancer or an inflammatory bowel disease (IBD)
  • without siblings or parents who have been diagnosed with colon cancer before age 60
  • with no more than two relatives diagnosed at any age

Keep reading to learn more about these tests and see our picks for the best FIT options.

What is a FIT?

FIT is one type of colon cancer screening test that uses a stool (feces) sample. FIT screening checks for blood (hemoglobin) in your stool.

Blood in your stool, which may not be visible, can come from unusual growths in the colon or from other causes such as hemorrhoids.

FIT samples are often self-taken at home, even when the test is ordered by a doctor. This makes kits a good idea for sample collection. FITs can be convenient, less invasive, and more cost effective for people. They can be useful screening tools for preventive healthcare.

According to the American Cancer Society, FIT screening must be done yearly to appropriately check colon health.

We looked for tests that:

  • you can easily take at home
  • are approved by the Food and Drug Administration (FDA)
  • are made by companies that use College of American Pathologists (CAP) accredited and Clinical Laboratory Improvement Amendments (CLIA) certified laboratories
  • are made by companies that offer good customer service and support

Pricing guide

  • $ = under $50
  • $$ = $50–$100
  • $$$ = over $100

Best FIT with subscription option

Everlywell

  • Price: $

Everlywell offers a range of at-home health tests, including a FIT kit.

A bonus of using this test is that Everlywell offers other services along with the test, like help with understanding results, the ability to chat with one of their physicians about test results, and other resources for colon cancer.

The drawback is that this kit requires you to handle stool to send it to one of the Everlywell labs. You can do this by using the brush provided in your kit. You’ll need to brush your stool for about 5 seconds before the brush is dabbed onto the test card, only transferring the water onto the card. Then, you’ll do the process again using a second brush.

Everlywell works only with labs that are CLIA certified, meaning the labs must meet high standards to get both state and federal certifications. Plus, these labs must also submit themselves to regular inspections.

Everlywell has a membership program for $24.99 per month that offers access to a qualifying test every month. So, if you’d like to perform other health checks from home, like an HIV test or cholesterol test, Everlywell makes that easy.

Everlywell accepts health savings account (HSA) and flexible spending account (FSA) cards. They also offer free shipping for both receiving the kit and sending the sample.

Pros

  • Everlywell offers physician assistance from their network if there’s a positive result.
  • Users can access more information on colon cancer, the test, and other wellness information.
  • Results are easy to download and share with your doctor.
  • Membership program gives access to other at-home health tests.

Cons

  • Higher cost compared with other tests.
  • You need to handle stool to send the sample to a lab.

Best FIT with fast lab results

LetsGetChecked

  • Price: $$

LetsGetChecked offers a slew of at-home health tests — 34 different tests, to be exact.

Their FIT requires you to collect your stool sample for lab testing. After your bowel movement, you’ll gather the provided tube. Then, you’ll dip the sample stick end into your stool until the end of the stick is covered.

Finally, you’ll put the stick back into the provided tube and fasten the cap securely before placing the tube in the provided bag and box and then sending it off to the lab. The sample should be sent to the lab the same day it’s taken.

If your test is positive, LetsGetChecked might offer you a referral to a gastroenterologist or encourage you to visit your primary care physician for further testing.

One perk with this brand is that your results can be available in just 2 to 5 days.

This company also accepts HSA and FSA cards.

Pros

  • Nurse assistance is available to discuss positive results.
  • Results are easy to download and share with your doctor.
  • Kits arrive in unmarked packaging for privacy.
  • Results are available in 2 to 5 days.

Cons

  • Higher cost compared with other tests.
  • You need to handle stool to send the sample to a lab.
  • Restrictions on sample returns: no returns on Friday, Saturday, or Sunday.

Best FIT with good lab reputation

Pixel by Labcorp

  • Price: $$

Labcorp has been around for more than 50 years. This network of CAP-accredited and CLIA certified laboratories says they handle about 3 million patient samples every week.

For this test, you’ll register your kit online using the Pixel website. You’ll need to return your sample to FedEx by pickup or drop box on the same day you take it.

The website is a bit vague about how your sample is collected, but it does say that you’ll be provided with instructions, a wand, and capture paper.

A nice feature is that by purchasing the FIT, you have access to physician services from PWNHealth. You can expect the company to contact you if your test comes back positive. Since PWNHealth does receive test results, this could be considered a drawback for those who want results to remain private.

Pros

  • Results are easy to download and share with your doctor.
  • Labcorp offers access to an independent physician group.
  • The company has a well-established network of labs.

Cons

  • Higher cost compared with other tests.
  • You need to handle stool to send the sample to a lab.

Best FIT to purchase in person

Pinnacle Biolabs

  • Price: $

According to Pinnacle Biolabs, their test has been the bestselling colon cancer screening test in the United States for 6 consecutive years.

To perform this test, you’ll collect your stool sample using a tube with an attached wand. You’ll gather your stool with the wand and then put it back into the tube. Next, you’ll add three drops of the provided solution to the test cassette. The window on the test will give you your results in just 1 to 3 minutes.

Two lines indicate a positive test result, which means that blood is present in the stool. One line indicates a negative result.

You can buy it online or find it at major retailers. This test is tax-free and ships free.

Pros

  • It’s FDA cleared for over-the-counter use.
  • It’s affordable compared with similar tests.
  • It’s easy to find in stores.
  • Test is done fully at home, no mailing required.
  • Results are presented within minutes.

Cons

  • You need to handle stool.
  • It doesn’t come with online support.

Best FIT DNA test

Cologuard

  • Price: $$$

This is a FIT DNA test to screen your stool.

The website explains that each day, your colon sheds cells that line it. During this routine, altered and unaltered cells are shed. During bowel movements, these cells are collected in your stool as it goes through the colon. The FIT DNA test identifies these cells to detect both precancer and cancer.

This makes Cologuard unique compared with other tests on this list, since it looks for the presence of DNA markers as well as blood (hemoglobin) in the stool. This makes it a more sensitive test, and the only FIT-type test on the list able to detect nonbleeding polyps.

One thing to keep in mind is that results are reported as positive or negative without differentiating which part of the test returned positive (DNA vs. blood). Following up with a health professional and likely another test is key.

People between the ages of 50 and 75 may be able to get Cologuard without any out-of-pocket cost. For those without insurance or with insurance plans that don’t cover it, the maximum price for this test is $649.

This test is also FDA-approved.

Pros

  • It’s FDA-approved.
  • It can detect both precancer and cancer.
  • It’s covered by Medicare and many major insurance companies.

Cons

  • It’s available by prescription only.
  • You need to handle stool to send the sample to a lab.

There are a few key factors to consider before ordering your FIT test.

First, if you have insurance, decide if you prefer to use a test that accepts your coverage. If you don’t mind paying out of pocket, you may be able to consider more options.

Next, consider whether you’re comfortable directly handling stool or not. The sample collection process for some tests is more involved, while others are more flexible.

Finally, look at how long some companies take to give you results. Results may take just a few days or up to a couple of weeks in some cases. You can also opt for a kit like the one from Pinnacle Biolabs, which gives you results in minutes at home.

FIT testPriceFDA approvalResults turnaroundPhysician consultationAccepts insurance or HSA/FSAFeatures
Everlywell$no5 days contacted only with positive test resultHSA/FSA onlymembership offers access to other tests monthly
LetsGetChecked$$yes2–5 daysnursing team availableHSA/FSA onlykit arrives unmarked for privacy
Pixel by Labcorp$$nonot listedcontacted by PWNHealth for certain test resultsHSA/FSA onlywell established network of labs
Pinnacle Biolabs$FDA-cleared for OTC use4–7 minutes noneitherfully done at home, results in minutes
Cologuard$$$yes2 weeks 5–20 minute session with a PWNHealth provider available•accepts insurance
may accept HSA/FSA
also tests DNA, detects both precancer and cancer

A FIT kit is a good choice for anyone who:

  • doesn’t have a history of colon cancer or IBD
  • doesn’t have siblings or parents who were diagnosed with colon cancer before age 60
  • has two or fewer relatives diagnosed at any age

Otherwise, it’s best to contact your doctor for a colonoscopy or sigmoidoscopy instead.

And regardless of risk factors, colonoscopy is the gold standard for colorectal cancer screening.

Other than being ready for a bowel movement, there’s no prep work required.

It’s best not to take stool tests during your menstrual period or while actively bleeding from hemorrhoids.

Most kits include similar instructions, but be sure to read yours carefully.

Some kits screen fully at home, without having to send in a sample to a lab to receive results. Some kits require direct contact with your stool and need you to send the sample for results. Make sure you know exactly what your kit will require of you before purchasing.

For kits that require you to send your sample for testing, make sure you write down any necessary information on your kit, including your name, the date, and so on.

After you have completed the necessary collection method, you’ll carefully package the materials in the provided box and follow instructions to send it for testing.

If your test result is negative, you can simply plan on doing another test in 1 year or when your healthcare team advises.

If your test result is positive, this means there is blood in your stool. Schedule an appointment with your doctor to look into it further.

Although FIT tests are a convenient way to screen for colon cancer from home, they are no substitute for talking with your doctor and getting a colonoscopy. This is especially true for those who are at high risk of colon cancer.

You might be at a higher risk if you have:

  • a history of IBD or colon cancer
  • parents or siblings with a history of colon cancer before age 60
  • two or more relatives who have had colon cancer at any age

There are a few other lifestyle-related risk factors for colon cancer to consider as well, like alcohol intake, physical activity levels, and smoking.

The Centers for Disease Control and Prevention (CDC) recommends that people between ages 45 and 75 get checked regularly for colon cancer.

According to a 2021 review, only 67 percent of patients in the United States are up to date with their colorectal cancer screening. The hope is that FIT may help bridge the gap in regular screening for those at average risk who may have less access to a colonoscopy or who simply prefer a less invasive and more convenient screening option.

Here are the main differences between colonoscopies and FITs.

Colonoscopies require more prep work

Colonoscopies are the gold standard for testing for colon cancer, but they’re also considered a hassle for a few reasons. They generally require unpleasant prep work, diet or medication restrictions, and time off from work or school. And of course, while they’re not painful, they can be uncomfortable.

FITs must be done more frequently than colonoscopies

Although 2019 research shows FIT is nearly as effective as colonoscopies, one drawback is that you must do it yearly to detect colorectal cancer. This is much more frequent than the even more accurate, though uncomfortable, colonoscopies.

Colonoscopies are more accurate and a better choice if you’re at high risk

Those at high risk of colon cancer — including those with a family history, prior colon cancer diagnoses, or history of IBD, as well as other known risk factors — should get a colonoscopy.

Colonoscopies, like most procedures, have a few risks. A 2011 report from the American Society for Gastrointestinal Endoscopy states that there are fewer than 3 serious complications for every 1,000 procedures performed on people with an average risk of colorectal cancer, and a follow-up review from 2019 found that the level of risk had stayed the same over time.

Is an at-home FIT accurate?

While FITs are almost as useful as colonoscopies, these tests are still susceptible to user error. Research from 2018 suggests there’s also a risk of false-positive and false-negative results.

Colonoscopies are considered to be the gold standard. In other words, they may be the absolute best way to screen for colon cancer, especially for those who are at high risk.

Is a FIT test as good as a colonoscopy?

A 2019 review shows FITs are almost as effective as colonoscopies, but colonoscopies are considered the gold standard in screening. They’re even more accurate, and they’re necessary for those with a high risk of colon cancer.

Is a FIT test the same as Cologuard?

A FIT test is a fecal immunochemical test, while Cologuard is a particular test. Cologuard is different compared with other FIT options, because it looks for certain DNA markers and can test for both precancer and cancer. Meanwhile, most FITs just test for the presence of blood.

When should you take an at-home colon cancer test?

Doing a FIT is a good option for those at average risk of colon cancer who are looking to avoid the hassle of a colonoscopy, have less access to colonoscopies, or just prefer a less invasive screening option and don’t mind doing a FIT every year.

How can colon cancer be detected without a colonoscopy?

Colon growths and polyps in the large intestine that can become cancerous may cause bleeding. A FIT can detect unseen blood in the stool. Blood in the stool may signal the presence of these growths or polyps.

How does the FIT compare with the gFOBT?

The guaiac-based fecal occult blood test (gFOBT) is another type of test that detects blood in the stool.

Experts in a 2018 review considered FIT to be the better testing option for a couple of reasons. Not only is the FIT more effective at detecting blood in the stool, but it also doesn’t require any prep before testing.

Does insurance cover at-home FIT kits?

Insurance may cover some FIT kits, but it’s not a guarantee. If you have insurance, it’s a good idea to call your provider to find out about cost. If your insurance doesn’t cover the cost of FIT, some affordable options are available.

FIT kits test for blood in the stool, which is often a sign of colon cancer.

These tests come in a range of styles and prices. Some can fully screen at home, while some require you to send a sample to a lab for test results.

The FIT is a good option for those at average risk of colon cancer who would like to avoid the fuss of prep time and a doctor’s visit for a colonoscopy.

People at high risk of colon cancer should still undergo a colonoscopy.

Those who opt for the FIT will need to perform the test every year versus every 10 years for a colonoscopy.


Breanna Mona is a writer based in Cleveland, OH. She holds a master’s degree in media and journalism and writes about health, lifestyle, and entertainment.