Historically, the gold standard for diagnosing colorectal cancer has been a colonoscopy. During the procedure, a thin tube with a camera is inserted into the rectum, which lets the doctor examine the inside of the colon and look for abnormal growths.
But in the United States, colonoscopies are only routinely done in people who are 45 or older, have a family history of colon cancer, or have suspicious symptoms like rectal bleeding or pencil-thin stools.
Many people put them off since they’re invasive and expensive, which has led to millions falling behind on their routine cancer screenings. Furthermore, as colorectal cancer rates increase in young people, many folks in their 20s and 30s want to get screened, but don’t qualify for a colonoscopy.
One such solution is the fecal immunochemical test — aka the FIT. It’s quick, safe and effective — you simply collect a sample of your poop into a small plastic tube and mail it off to a laboratory that examines it for signs of cancer. And research suggests it’s highly effective — one recent study found that FITs cut the risk of dying from colon cancer by a whopping 33%.
Here’s what to know if you’re interested in doing one.
Here’s how the FIT works.
Unlike colonoscopies (which visually look for irregular growths with a camera), the FIT examines stool samples for human hemoglobin, a protein in red blood cells. If human hemoglobin is present, blood has likely leaked into the digestive system, according to Dr. Theodore R. Levin, a gastroenterologist with Kaiser Permanente in Northern California.
Why does this matter? Well, cancerous tissue — and even large benign polyps — is more likely to bleed than normal health tissue in the colon, Levin said. But the blood isn’t always noticeable when you go to the bathroom. In fact, the FIT was designed because growing polyps and cancers tend to microscopically bleed, according to Dr. Luigi Ricciardiello, a professor of medicine in the department of gastroenterology, hepatology and nutrition at The University of Texas MD Anderson Cancer Center in Houston.
A positive result indicates there’s blood in your stool, which could mean you have colorectal cancer. That said, abnormal test results do not automatically mean you have cancer, as there are other health conditions, like hemorrhoids or benign polyps, that also cause bleeding. If your FIT finds blood, however, you’ll definitely want to follow up with a colonoscopy to get an accurate diagnosis, Levin advised. “A positive FIT test should never be the end test. A next step is needed,” Ricciardiello said.
How effective are FITs?
Very. A single test can detect up to 84% of colorectal cases. And even if you don’t catch it the first time around, you have a very high chance (about 75%) of catching it during a subsequent test, research shows. “Many of the growths that might be missed the first time the test is used can be detected on the second time the test is run,” Levin said.
One quick caveat: Some people may get a false negative result — up to 10%, evidence suggests. In such cases, people may be falsely reassured that they don’t have colon cancer when, in fact, they do.
Who qualifies for a FIT?
Currently, anyone who is due for colon cancer screening should be able to do the test without a copayment, thanks to the Affordable Care Act. This includes people over 45 or those with a family history (meaning you have a first-degree relative who had colon cancer).
- Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis.
- A personal or family history of colorectal cancer or colorectal polyps.
- A genetic syndrome such as familial adenomatous polyposis (FAP) or hereditary non-polyposis colorectal cancer (Lynch syndrome).
Those under 45 can just pay out of pocket; that’s a conversation to have with your doctor, or you can try the direct-to-consumer route, which we’ll talk more about below.
Here’s why the FIT is such a game-changer.
There is one big disclaimer about the FIT, and that’s that it should only be used if you’re asymptomatic. If you have constant stomach pain, unintended weight loss or blood in the stool, you’ll want to skip the FIT and go straight to a colonoscopy, Ricciardiello said.
Only 70% of age-eligible adults are up to date with their colon cancer screening. Research shows many people avoid colonoscopies because they’re afraid of being sedated or doing the preparation (if you haven’t had one, it involves some heavy-duty laxatives). Others say they didn’t know they needed to be screened, weren’t aware of their family history or didn’t have any symptoms.
Alternatives that are less-invasive, more accessible and cost-effective are needed, which is why doctors are so excited about the FIT. It’s a safe, easy option for those who don’t want an invasive test, Levin said. And if people do it regularly, they have a high chance of catching cancer early when it’s most treatable, he added.
Plus, it may be an effective option for younger adults who are worried about the growing rates of colorectal cancer but don’t have the classic symptoms or family history that’ll get them a colonoscopy.
This article originally appeared on HuffPost.