Colonoscopies are the top-recommended screening for colorectal cancer, which is is the second most common cause of cancer deaths in men and women. In adults aged 50-64, rates are climbing.
Yet some people avoid their screenings due to fear, inconvenience or discomfort — and not even from the rectal camera. (The pre-procedure laxative solution meant to flush the bowels out is infamous.)
But a new study out of Spain found that a non-invasive test — that can be done entirely at home — can also seriously save lives from colon cancer.
“It’s extremely easy for patients. It’s non-invasive, and it’s quick and simple,” Dr. Alexis Grucela, a colorectal surgeon at Northwell Northern Westchester Hospital, told The Post.
This study looked at people age 50 to 69 who participated in a 21-year program. During that time, every two years, they did an fecal immunochemical test, or FIT.
No prep is needed for an FIT. There’s no disruption to drinking, eating or meds normally taken. Simply order a kit and collect a stool sample at home, then return the container for lab testing, often by mail.
Over the course of the study, deaths among adults aged 50 to 69 who completed the program dropped by 50%.
“It shows that once everybody started utilizing the testing, it could have an impact,” Grucela said. Researchers examined data from 2.2 million people. “This is a pretty impactful study because it’s such a large population that was studied.”
What’s the difference between FITs and other at-home tests?
An FIT, sometimes called a fecal blood test, looks for blood in the stool, a sign of colon cancer.
Grucela says “it’s a lot less costly” than multitarget stool DNA tests, like Cologuard, which find DNA in the stool.
FITs “doesn’t require insurance approval or authorization. It’s more ubiquitous, and it could be used at any time by any provider,” she added.
There’s another test, gFOBT, that detects blood in stool, but requires a bit more prep. Certain foods and medicines must be avoided, and the test is a bit longer — samples from three bowel movements in a row are required.
The FIT finds cancer and polyps or advanced adenomas better than the gFOBT, according to Mayo Clinic. An FIT is also less likely to deliver a false positive compared to the other two tests.
That said, the DNA test finds advanced lesions better than the other tests and is recommended every three years. The other tests are recommended every year.
Anyone can order an FIT — primary care doctors, nurses, and physician assistants — but you can also order one directly through lab services without a doctor’s visit.
Plus, no fasting, no laxatives, no going under anesthesia, which are typical of a colonoscopy.
“Overall, it’s something that all healthcare providers could utilize and encourage patients to do,” Grucela said. “it’s easier to use, it’s easier to perform, more providers can utilize it, and it’s easy for patients.”
FIT isn’t a replacement for a colonoscopy
Without insurance, colonoscopies require specialized doctors and can cost thousands of dollars. An FIT costs less than $100 out of pocket.
But it’s not a one-to-one swap. Patients might utilize an FIT to find cancer early. If the FIT comes back positive, they’d have to get a colonoscopy.
A colonoscopy has multiple functions: it can cut out precancerous polyps and prevent cancer, but also can biopsy a suspicious mass to see if it’s cancerous. In contrast, an FIT is a screening only, and cannot confirm a patient has cancer.
Plus, not everyone is a good fit for FITs. If you have symptoms of colon cancer — like abdominal pain or a change in bowel habits — or a risk of colon cancer because of family history, a colonoscopy is best.
The value of an FIT, Grucela says, is providing an affordable, readily accessible option for people who can’t access a colonoscopy, or are between colonoscopies, which is recommended every 10 years for average risk adults.
“Any screening is impactful and helpful,” Grucela said. “Screening works, and it helps prevent death from colorectal cancer.”
