Traditionally, colonoscopies have been the go-to method for diagnosing colorectal cancer. This procedure involves inserting a thin tube with a camera into the rectum so that physicians can inspect the colon for any abnormal growths.
However, in the U.S., colonoscopies are typically performed only on people aged 45 and older, or those with a family history of colon cancer, or people experiencing concerning symptoms like rectal bleeding or very thin stools.
Many avoid the procedure because it’s invasive and can be costly, resulting in millions missing out on routine screenings. With rising rates of colorectal cancer among younger individuals, particularly in their 20s and 30s, there’s a growing desire for screening, yet many don’t qualify for a colonoscopy.
One potential answer to this issue is the fecal immunochemical test, or FIT. This test is quick, safety-conscious, and straightforward—you just collect a small stool sample and send it to a lab, which checks for signs of cancer. Research indicates it’s highly effective; a recent study suggested that FITs could lower the risk of dying from colon cancer by about 33%.
Now, let’s unpack how the FIT works.
Unlike colonoscopies, which visually search for growths, FIT analyzes stool samples to detect human hemoglobin, a protein found in red blood cells. The presence of this protein may signal that blood has leaked into your digestive system, as noted by Dr. Theodore R. Levin, a gastroenterologist.
This is significant because cancerous tissues and even larger benign polyps are more prone to bleeding than healthy tissues. Often, blood is not visible during bathroom visits; the FIT was developed because such growths tend to cause microscopic bleeding, explains Dr. Luigi Ricciardiello from The University of Texas MD Anderson Cancer Center.
A positive FIT result indicates blood in the stool, which may suggest colorectal cancer. However, not all positive results mean cancer; conditions like hemorrhoids or benign polyps can also produce bleeding. If your FIT turns out positive, a follow-up colonoscopy is essential for an accurate diagnosis, according to the doctors.
How effective are FITs?
The effectiveness of FITs is impressive. A single test can identify up to 84% of colorectal cancer cases. Even if cancer isn’t detected initially, the chances of identifying it in later tests remain high—around 75%. As Dr. Levin highlights, many growths might be picked up on subsequent tests that were missed the first time around.
Nevertheless, there’s a chance of receiving a false negative result—up to 10%—which can mislead individuals into thinking they are cancer-free when they might not be.
Who can take a FIT?
Currently, anyone scheduled for colon cancer screening is eligible for the FIT without needing to pay a copayment, thanks to the Affordable Care Act. This includes folks over 45 or those with a family history of colon cancer—meaning a first-degree relative who has had it.
For individuals under 45 to qualify, they would need to be at higher risk due to specific factors. Those younger than 45 can consider paying out of pocket for the test or obtaining it through direct-to-consumer services. But note that the FIT is only advised for those who are asymptomatic; if you’re experiencing significant stomach pain, unintentional weight loss, or blood in your stool, you should go straight for a colonoscopy.
Why the FIT matters
The FIT represents a significant advancement primarily because only about 70% of eligible adults are up to date with their colon cancer screenings. Research shows that many avoid colonoscopies due to concerns about sedation or preparation, which can be quite extensive. Others might not even know they need screening or lack awareness about their family health history.
Alternatives like the FIT offer a less invasive, more accessible, and cost-effective way to encourage routine screening, which could lead to early detection when cancer is most treatable. Many younger adults, seeing rising colorectal cancer rates yet not qualifying for traditional screenings, may find FIT particularly beneficial.
FIT kits are available online from companies such as Everywell for about $49 or Labcorp for around $89. If the result turns positive, further consultations with a healthcare provider will be necessary for thorough evaluation. Alternatively, as suggested, going through a physician to request a test kit could streamline the process and ensure timely follow-ups.
