Colon cancer deaths were cut in half for individuals who participated in a home-based screening program using fecal immunochemical tests (FIT), according to a new study. The 21-year program involved participants aged 50 to 69 who completed an FIT every two years.
FIT kits are non-invasive and require no special preparation, such as laxatives, unlike colonoscopies. Users collect a stool sample at home and return it for lab testing, often via mail. The study, which examined data from 2.2 million people, showed a 50% drop in deaths among those who consistently used the FIT testing.
"It shows that once everybody started utilizing the testing, it could have an impact," said Dr. Alexis Grucela, a colorectal surgeon at Northwell Northern Westchester Hospital. "This is a pretty impactful study because it’s such a large population that was studied."
FIT tests, also known as fecal blood tests, detect blood in the stool, which can be an early indicator of colon cancer. They are generally less expensive than multitarget stool DNA tests like Cologuard and do not require insurance approval, making them more accessible. While another test, gFOBT, also detects blood, it requires dietary and medication restrictions and samples from three consecutive bowel movements.
According to the Mayo Clinic, FITs are more effective at finding cancer and precancerous polyps than gFOBT and are less prone to false positives. However, DNA tests are better at detecting advanced lesions and are recommended every three years, while FITs and gFOBT are recommended annually.
While FITs are a valuable screening tool, they are not a replacement for colonoscopies. A positive FIT result would necessitate a follow-up colonoscopy. Colonoscopies can also remove precancerous polyps and biopsy suspicious tissue, functions that FITs cannot perform. For individuals with symptoms of colon cancer or a family history, a colonoscopy remains the preferred method. FITs offer an affordable and accessible option for those who might otherwise not undergo screening, or as a supplement between recommended colonoscopies, which are advised every 10 years for average-risk adults.