The home health test that may save your life
A fecal immunochemical test (FIT) is a simple and fast way to screen at home for colorectal cancer. Learn more about this convenient alternative to a traditional colonoscopy.
Screening guidelines for colorectal cancer have changed in recent years because of increasing rates of the disease among people younger than 50. According to the American Cancer Society, patients at average risk should start screening for colorectal cancer (CRC) at 45.1 Colorectal cancer is the fourth most common cancer in the U.S.2
You may be familiar with the colonoscopy, an examination of the inside of the large intestine that uses a flexible tube with a lens at the end. The good news is that a colonoscopy (and its preparation process) is no longer the only way to look for signs of CRC. Now, there are more options to consider.
A simple, noninvasive home test can perform an initial assessment for signs of colorectal cancer for people who aren’t at high risk. This fecal immunochemical test (FIT) has several advantages over a colonoscopy, including no prep and being able to complete it at home. For most people, it’s a process that’s fairly simple to complete.
Why screen for colorectal cancer?
Colorectal cancer (CRC) occurs when cells in the colon or rectum grow out of control. Polyps (abnormal growths) may form in the colon or rectum and may become cancerous over time.2
Screening enables your doctors to find and remove polyps before they turn into cancer. It also helps to identify colorectal cancer at an early stage. That’s when treatment has the best chance for success.
Who should take the fecal immunochemical test (FIT)?
The FIT is a common starting tool to screen for CRC. It’s recommended for screening patients with an average risk of CRC starting at age 45. The American Cancer Society recommends repeating the test annually.
Other patient criteria include.1
- No history of inflammatory bowel disease (IBD)
- No personal or family history of colon cancer or specific types of polyps
- No lower gastrointestinal symptoms, which may be caused by hemorrhoids
What does a FIT look for?
“The fecal immunochemical test checks for blood in stool that can’t be seen with the naked eye,” explains Marcie Klein, senior vice president of prevention at the Colorectal Cancer Alliance. “This can be a sign of colorectal cancer, and an abnormal test result should be followed by an immediate colonoscopy.”
Larger colorectal cancers or polyps are often fragile and easily damaged by passing stool, which may cause them to bleed. The small amounts of blood they emit into the colon or rectum may not be visually detectable.3
Because trace amounts of blood in the stool could also come from other conditions such as hemorrhoids or ulcers, the FIT can’t conclusively detect the presence of CRC. Confirming colorectal cancer requires a visual screening by way of a colonoscopy.3
FIT vs. colonoscopy
“FITs are less invasive than a colonoscopy, don’t need any preparation, and can be completed at home,” says Klein. “They’re also available over the counter at drugstores. FITs can be a really good screening choice for people at average risk who have time constraints or work constraints or are looking for a less invasive option.”
But they’re not foolproof. “FITs are not as effective as a colonoscopy when it comes to detecting polyps,” says Klein. “And a colonoscopy lets a gastroenterologist remove polyps too, ensuring they never develop into cancer. Plus, they’re less sensitive [to CRC detection], so users should test annually, versus every 10 years with a colonoscopy.
| FIT | Colonoscopy | |
|---|---|---|
| What is it? | Looks for blood traces in stool | Looks for polyps |
| How? | Tests a small sample of your stool |
Inserting a scope into your rectum and colon |
| Where? | At home | At a medical facility under sedation |
| How often? | Yearly | Every 10 years |
| What if my test is positive? | Schedule a closer look with a colonoscopy | Remove and biopsy the polyps |
| Any prep? | None | Full bowel prep including fasting and laxatives |
| Time it takes? | Very little | Plan to take the day off from chores and activities |
| Cost? | At no additional cost to you | May be no additional cost |
How to complete your FIT at home
Here’s the good news: You don’t need any specific preparations to take this test. This may be a welcome contrast to the extensive prep required for a colonoscopy.
Always follow your FIT kit’s specific instructions. Here are typical steps you’ll complete at home.4
- Flush your toilet prior to having a bowel movement.
- Dispose of used toilet paper in the waste bag provided, not in the toilet bowl.
- Take the brush from the kit and brush the surface of the stool.
- Dip the brush into the toilet water.
- Apply the brush to the space indicated on the test card.
- Discard the brush in the provided waste bag.
- Send the sample to a lab for testing.
While this process may seem a bit unappealing, as Klein notes, “A moment of ‘ick’ is worth saving yourself from the life-changing burden of an advanced colorectal cancer diagnosis.”
Where to get your FIT kit
Talk to your primary care provider about your risk for colon cancer and the best screening strategy. They may issue you a FIT to take home, recommend getting one from a pharmacy or refer you to a gastroenterologist.
Early cancer detection is essential for a better outcome. If you’re not at high risk for colorectal cancer, a fecal immunochemical test can be a simpler and faster way to perform your annual screening for this common and dangerous type of cancer.
