You may know that colorectal cancer screening is important and should begin by age 45. And you may know that colorectal cancer is the third highest cause of cancer deaths in the U.S., even though it’s 90% treatable if caught early. But something is still holding you back from getting your recommended colorectal cancer screenings.

Some people put off colorectal cancer screening because they don’t want to have a colonoscopy. But the good news is that you may be able to start the screening process with a FIT test, a noninvasive test that you do at home. The following story shares how one patient used a FIT test as part of the colorectal cancer screening process.

Annette’s colon cancer screening story

(To protect the patient’s privacy, a fictitious name is being used.)

Annette is a 61-year-old African American woman. She is physically active, works full time and has three grown kids. She’s also a HealthPartners patient.

Every year since Annette became eligible for screening, her doctor has recommended a colonoscopy to screen for colon cancer. And each year, Annette has politely declined. She had heard from friends and relatives that colonoscopies (and the preparation for a colonoscopy) can be uncomfortable. Besides, Annette was healthy, and no one in her family ever had colon cancer or polyps. So, did she really need a colonoscopy?

The truth about colonoscopies

The simple truth is, getting a colonoscopy is worth it because it can save your life. A colonoscopy is the best way to screen for colon and rectal cancer and find it early, when it’s most treatable. But if you keep putting off screening because you have concerns about colonoscopy preparation or the procedure itself, doing the FIT test can be a good first step to help you determine if a colonoscopy is right for you.

Taking a step towards screening: Annette and her at-home FIT test

When Annette came into the clinic for her annual checkup this year, she again declined a colonoscopy. But when her doctor made a follow-up suggestion for a FIT test, which is short for fecal immunochemical test, she agreed to try it.

A FIT test works by looking for hidden blood in your stool. If there is blood in your stool, it can be a sign of cancer or another condition, and you’ll need a follow-up colonoscopy. If the test finds no blood (which is what happens most of the time) it’s likely that you’ll be able to simply complete another FIT test next year. Your doctor will discuss this option with you.

Annette took home the FIT kit, followed the instructions and mailed it to the lab two days later. The next week she received her results, which showed some blood in her stool. With that information, Annette agreed to schedule a colonoscopy.

Annette’s follow-up colon cancer screening

During the colonoscopy, Annette’s doctor found and removed a polyp. This growth had been the source of her bleeding. Thankfully, testing showed the polyp was not cancerous – but polyps can become cancerous over time.

Based on her results, Annette won’t need another colonoscopy for five years. At that time, they’ll check to make sure that no more polyps have developed. And as of now, Annette says she plans to get one again at that time.

“It really wasn’t that bad,” she said.

How HealthPartners has been innovating our use of the FIT Test

In Minnesota, only 68% of adults get the recommended colorectal screenings according to Minnesota Community Measurement (MNCM) data. And screening rates are even lower among non-English speaking patients at 52%.

At HealthPartners, we continue to explore ways to increase colorectal cancer screening and reduce disparities in screening rates among diverse populations. Since 2009, we’ve been using FIT tests as a first step toward helping patients achieve colorectal cancer screening. As a result, we’ve been able to identify patients who could benefit from a colonoscopy and find colorectal cancer sooner.

Here is a timeline of our colorectal cancer screening innovation.

2009: HealthPartners clinics begin mailing FIT tests to patients who elect them.

2014: Our Park Nicollet clinics begin routinely recommending the FIT test. In just 6 months, screening rates increase by 7%. Among populations of color, screening rates improve even more – by 10%.

2015: Our HealthPartners clinics streamline their FIT process. Before, patients had to respond to a letter each year and say they agreed to complete a FIT again. So, HealthPartners cuts that letter from the process. They instead begin mailing an annual FIT test to anyone who has completed one in the past. That makes the test even more convenient for patients.

2017: Four Park Nicollet clinics pilot a new approach to mailing FIT tests, sending the test to any eligible patient who has never before had a colon cancer screening. This results in FIT tests arriving for the first time in the mailboxes of 6,000 patients. About 25% of the tests were completed – and those clinics’ screening rates go up 6%.

HealthPartners clinics build on this pilot to reduce the racial disparity that exists in colorectal cancer screening, sending FIT kits specifically to 46- to 75-year-old patients of color who have never been screened for colon cancer. This results in 3,000 tests being mailed. And once again, about 25% of the tests are returned. This boosts screening rates by 3.5%.

2018: HealthPartners is named the Colorectal Cancer Organization of the Year for this work.

Today: 60% of our patients of color who are eligible for screening receive either a FIT kit to begin their process or schedule a colonoscopy.

With many HealthPartners and Park Nicollet cancer clinics throughout the Twin Cities and western Wisconsin, options to support screening and colorectal cancer treatment are always close to home.