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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
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
Our Brand and Content Integrity team also vetted all the options on our list, ensuring that each test met our medical and business standards.
| FIT test | Price | FDA approval | Results turnaround | Physician consultation | Accepts insurance or HSA/FSA | Features |
|---|---|---|---|---|---|---|
| Everlywell FIT Colon Cancer Screening Test | $49 | no | 5 days | contacted only with positive test result | HSA/FSA only | membership offers access to other tests monthly |
| LetsGetChecked at Home Colon Cancer Screening Test | $89 | yes | 2–5 days | nursing team available | HSA/FSA only | kit arrives unmarked for privacy |
| Labcorp OnDemand Colorectal Cancer At-Home Test | $89 | no | not listed | contacted by PWNHealth for certain test results | HSA/FSA only | well established network of labs |
| Pinnacle Biolabs Second Generation FIT | $24.99 | FDA cleared for OTC use | 4–7 minutes | no | neither | fully done at home, results in minutes |
| Cologuard | $649 max | yes | 2 weeks | 5–20 minute session with a PWNHealth provider available | •accepts insurance •may accept HSA/FSA | also tests DNA, detects both precancer and cancer |
| QuestDirect FIT Colorectal Cancer Screening Test | $89 | no | 1 week for online results, 3 weeks for results in the mail | opportunity to speak with a licensed healthcare professional if blood is detected | may accept HSA/FSA | free patient portal offers easy results sharing |
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 like the QuestDirect FIT 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.
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
According to a
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.
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.
