Understanding the Fit Test: Your Simple Guide to At-Home Colorectal Cancer Screening

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Colorectal cancer, a leading cause of cancer-related deaths, can often be prevented or treated effectively with early detection. The Fecal Immunochemical Test (FIT) offers a simple, non-invasive, and affordable solution to colorectal cancer screening. This blog post will guide you through the ins and outs of the FIT test, helping you understand its importance in detecting colorectal cancer, determining if it’s the right test for you, and ensuring you’re well-equipped to perform and interpret the test results.

Key Takeaways

  • The Fecal Immunochemical Test (FIT) is a highly accurate and convenient colorectal cancer screening test with numerous benefits.

  • Individuals aged 45 and older who are at an average risk for colon cancer should consider the FIT Kit as part of their routine colorectal cancer screening.

  • With no dietary or medication restrictions required, the FIT test is noninvasive, convenient, cost-effective and has higher sensitivity than other tests.

Demystifying the Fecal Immunochemical Test (FIT)

Illustration of a FIT test kit

The Fecal Immunochemical Test (FIT) is a widely used colorectal cancer screening test that measures hemoglobin, a protein found in red blood cells, within a stool sample. The FIT test holds several benefits, including:

  • Zero direct risk to the colon

  • No requirement for bowel preparation

  • No changes to diet or medication before the test

  • The convenience of conducting the test from the comfort of your home

With an average sensitivity of 93% and a specificity of 91%, FIT is a valuable tool in detecting colon cancer early.

What is FIT and How Does It Detect Colorectal Cancer?

FIT is a noninvasive stool test that screens for colorectal cancer by detecting a specific type of blood in the stool. Those aged 45 and above are suitable candidates for the FIT test. The test evaluates the presence of blood in the stool, and if the result is positive, a follow-up colonoscopy is usually recommended for further evaluation.

One of the benefits of the FIT test compared to other tests is that it requires no drug or dietary restrictions prior to testing, and the sample collection process may be more straightforward.

The Importance of Early Detection with FIT

Detecting colorectal cancer early through FIT can significantly enhance treatment results and patient survival rates. The benefits of early detection include:

  • Increasing the 5-year survival rate of colorectal cancer up to 90%

  • Allowing for standard treatment options such as colonoscopy and surgery

  • Improving prognosis and overall patient outcomes

  • Emphasizing the importance of early detection through FIT screening

FIT’s efficacy in early detection is based on the fact that early colorectal cancers can cause bleeding, and minute amounts of blood can be detected in the stool before the onset of symptoms.

Who Should Consider a FIT Kit?

Illustration of a person considering a FIT kit

FIT tests are recommended for individuals of both genders who are at an average risk for colon cancer, starting at the age of 45. Factors that can increase an individual’s risk of developing colon cancer include:

  • Being overweight or obese

  • Lack of physical activity

  • Certain types of diets

  • Smoking

  • Alcohol consumption

  • Certain genetic syndromes

Routine colorectal cancer screening, including colon cancer screening, is recommended for those between the ages of 45 to 75 years, with a FIT test suggested every two years for individuals at an average risk.

Identifying Your Risk Level for Colorectal Cancer

Research suggests that the following factors may be associated with colorectal cancer:

  • Obesity

  • Diabetes

  • Consumption of red and processed meat

  • Tobacco use

  • Alcohol consumption

  • Certain genetic syndromes like Lynch syndrome

Age is also a strong predictor of the risk of developing colorectal cancer, with individuals over the age of 50 having a higher risk than those who are younger. Family history plays a significant role in determining the risk of colorectal cancer, with the risk nearly doubled for individuals with a family history and further increasing if other close relatives have had colorectal cancer.

Those with specific risk factors should seek advice from their primary care physician, who may propose an earlier start to colon cancer screenings to catch colon cancer early, following the American Cancer Society guidelines and considering the recommendations of the preventive services task force.

Ensuring FIT Test Coverage Through Your Insurance Provider

The majority of insurance policies typically include coverage for FIT testing for colorectal cancer. Providers such as:

  • Blue Community HMO

  • Blue Choice Preferred PPO

  • Medicare

  • Medicare Advantage

  • Medicaid

  • Certain private insurance plans

are known to offer coverage for FIT testing. To ensure up-to-date coverage, it is important to check with your insurance provider, especially with the recent change in the recommended screening age.

Preparing for and Performing the FIT

No preparation is required for a FIT test, making the screening process simple and accessible. Once you request a screening from your clinic, the testing kit will be delivered to your residence, and the entire test typically takes approximately five minutes to complete.

No Preparation Needed: The Ease of FIT Testing

One of the advantages of the FIT test is that:

  • No dietary or medication restrictions are required before testing

  • FIT testing offers greater sensitivity

  • No dietary restrictions are required

  • It is cost-effective compared to other tests like guaiac-based fecal occult blood tests (gFOBTs)

The simplicity of FIT testing makes it an attractive option for many individuals, as other colorectal cancer screening tests may present certain limitations or issues with preparation.

Step-by-Step Guide to Using Your FIT Kit

Photo of a person using a FIT kit

A standard test kit usually comprises a fecal immunochemical test card or tube, a collection brush or stick, usage instructions, and a return envelope or container for submitting the sample to the laboratory. To properly collect a stool sample for a FIT test, flush the toilet 2 to 3 times before collecting the sample, sit on the toilet and pass a bowel movement as normal through your digestive tract, use the collection stick provided in the test kit to gather a small amount of stool, and place the stool sample into the collection tube or container provided in the test kit, securely closing the container before sending it to the testing facility.

It is important to follow the instructions provided in the kit for proper storage and to be mindful of potential risks when conducting a FIT test.

Interpreting Your FIT Results

Comprehending your FIT test results is a key part of your colorectal cancer screening process. Here’s what you need to know:

  • A positive result on a Fecal Immunochemical Test (FIT) suggests the presence of blood in the stool sample.

  • However, a positive result does not necessarily imply that colorectal cancer is present.

  • Further assessment is required to identify the cause of the positive result.

On the other hand, a negative result implies that the test did not detect blood, thus suggesting a lower likelihood of colorectal cancer.

What Does a Positive FIT Result Mean?

Illustration of a positive FIT test result

A positive FIT result suggests the presence of blood in the stool and may necessitate further evaluation through a colonoscopy. Blood in the stool can indicate a wide range of health conditions such as ulcers, hemorrhoids, or others. It is important to speak to a healthcare professional if you experience this symptom..

In the case of a positive FIT result, medical professionals may recommend further diagnostic tests, such as a colonoscopy, to confirm the presence of colorectal cancer.

The Potential for False Negatives and Next Steps

The likelihood of false negatives with FIT tests is a consideration, and regular screening is essential for early detection. Studies have indicated that FIT tests can fail to detect approximately 8% of cancers and 60% of large polyps that are at increased risk of developing colon cancer.

In the event of a false negative FIT test result, it is imperative to consult your healthcare provider, who may advise additional screening tests, such as a colonoscopy, to further assess your colorectal health.

Comparing FIT to Other Colorectal Cancer Screening Tests

Illustration comparing FIT to other screening tests

Besides FIT, other colorectal cancer screening alternatives include:

  • Stool DNA test

  • Colonoscopy

  • gFOBT

  • Virtual colonoscopy

  • Flexible sigmoidoscopy

It is important to understand the differences between several screening tests and consider factors like personal preferences, risk factors, and accessibility when choosing the best screening option for your individual needs.

Stool-Based Tests vs. Visual Exams

Two types of tests used for colorectal cancer screening include stool-based tests like FIT and visual exams such as colonoscopy or sigmoidoscopy. However, the accuracy of the FIT test is generally lower compared to colonoscopy or sigmoidoscopy.

Colonoscopies are known to be highly accurate, with a rate of more than 99%, while the sensitivity for the FIT fecal DNA test is approximately 92%.

When to Choose FIT Over Other Screening Options

Age plays a significant role as a risk factor for colorectal cancer, with many expert groups suggesting FIT as an appropriate screening choice for those at average risk, starting at the age of 45. Additionally, FIT can detect more colorectal cancers than other tests.

FIT is a noninvasive, convenient, and cost-effective screening option for colorectal cancer that has been demonstrated to detect a high percentage of colorectal cancers with a higher degree of sensitivity and specificity than other tests.

Summary

In conclusion, the Fecal Immunochemical Test (FIT) is a simple, noninvasive, and affordable solution to colorectal cancer screening. Understanding the importance of early detection, assessing your risk level, and choosing the right screening option are crucial steps in the journey towards maintaining colorectal health. With the convenience and accessibility of FIT, there’s no reason not to prioritize your colorectal cancer screening and take control of your health.

Frequently Asked Questions

What is in a fit test?

The fecal immunochemical test (FIT) is an annual stool test used to screen for colorectal cancer. It uses antibodies to detect blood in the stool, which can be a sign of cancer. The FIT-DNA test combines the FIT with a test that detects altered DNA in the stool.

Is fit test as good as colonoscopy?

FIT-fecal DNA and colonoscopy have similar cancer detection rates, however colonoscopy offers more advanced polyp detection and removal before cancer can develop. Therefore, colonoscopy is the better choice for detecting and preventing colorectal cancers.

What is a fit test performed to determine?

The fecal immunochemical test (FIT) is a screening test performed to detect hidden blood in the stool, which can be an early sign of colon or rectal cancer. FIT only detects human blood from the lower intestines and is not affected by medicines or food.

How accurate is the fit stool test?

The FIT fecal DNA test has a sensitivity of 92%, making it accurate in picking up nine out of 10 cancers, while colonoscopies are more than 99% accurate. The FIT test uses antibodies to detect blood in the stool and is about 79% accurate in detecting colon cancer.

Which insurance providers cover FIT testing?

Many insurance providers, such as Blue Community HMO, Blue Choice Preferred PPO, Medicare, Medicare Advantage, Medicaid, and certain private insurance plans, offer coverage for FIT testing.

About the author 

Manpreet Batish

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