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Colon cancer often has few symptoms until it’s at an advanced stage. For this reason, everyone over age 45 is advised to screen for colon cancer. But not everyone wants to undergo a colonoscopy, which is the gold standard for ruling out colon cancer.
A fecal immunochemical test (FIT), which detects blood in the stool, is a less invasive way that people at average risk of colon cancer can check their colon health at home.
Along with being less invasive, FITs can be convenient and more cost-effective. According to the American Cancer Society, FIT screening must be done yearly to check colon health appropriately.
Read on to learn more about FITs and our recommendations for options to consider.
What is a FIT?
FIT is one type of colon cancer screening test that uses a stool (feces) sample and checks it for blood (hemoglobin).
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.
FIT might be a good option for people at average risk of colon cancer, or those:
without lower gastrointestinal symptoms, as can come from hemorrhoids
Regardless of risk factors, colonoscopy is the gold standard for colorectal cancer screening. FITs should not be considered 100% accurate, but they may help lead to early diagnosis for those who might otherwise skip a colonoscopy.
There are a few key factors to consider before ordering your FIT.
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.
Also, 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.
Doing a FIT once a year is a good option for those at average risk of colon cancer who don’t want to undergo a colonoscopy, have less access to colonoscopies, or prefer a less invasive screening option and don’t mind doing a FIT at home.
Colonoscopies are the benchmark method for testing for colon cancer, but they’re not popular for a few different reasons. They generally require disruptive preparation, including diet or medication restrictions and taking laxatives.
Colonoscopies are often performed under general anesthesia, although other options may be available. They also mean time off from work.
And while they’re not painful, they can be uncomfortable.
According to a 2021 review, only 67% of people in the United States are up to date with their colorectal cancer screening.
FIT may help bridge the gap in regular screening for those at average risk of colon cancer who may have less access to a colonoscopy or who simply prefer a less invasive and more convenient screening option.
Other than being ready for a bowel movement, there’s no prep work required for using a FIT.
Testing generally requires that you brush your stool with a provided tool and transfer the sample to a test card or paper, which you will then put into a provided container. You’ll write your name, date, and other important information before mailing your sample lab in the included prepaid packaging.
Most kits include similar instructions, but be sure to read yours carefully.
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 FITs 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.
FITs use antibodies to check for blood in stool. If blood is detected, you’ll need to follow up with your doctor, who can perform a colonoscopy to rule out colon cancer.
No. FITs are less invasive than colonoscopies, but colonoscopies are the gold standard for colon cancer screening.
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.
However, a 2023 study, reports that FITs perform poorly at predicting the presence of polyps. Colonoscopies, on the other hand, more closely detect polyps.
One 2020 review of 44 studies showed that FITs correctly identified four out of five cases of colorectal cancer. These detected cases stages were 2 through 4.
It’s important to note that the test sensitivity was shown to be lowest for the earliest stages. With colon cancer, early detection is crucial.
One other drawback is that you must do FITs yearly to detect colorectal cancer. This is much more frequent than the even more accurate, though uncomfortable, colonoscopies.
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.
FIT kits test for blood in the stool, which is often a sign of colon cancer. Some tests 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.
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de Klerk CM, et al. (2018). Participant‐related risk factors for false‐positive and false‐negative fecal immunochemical tests in colorectal cancer screening: Systematic review and meta‐analysis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6768609/
Imperiale TF, et al. (2019). Performance characteristics of fecal immunochemical tests for colorectal cancer and advanced adenomatous polyps: A systematic review and meta-analysis. https://www.acpjournals.org/doi/10.7326/M18-2390
