Have you been putting off your colon cancer screening?

We get it. Colorectal cancer screening may not be at the top of your to-do list. Maybe you think you’re healthy and don’t need to be screened. Or perhaps you’re uncomfortable with the idea of a colonoscopy.

But, it’s important to follow colorectal cancer screening guidelines – even if you’re healthy. That’s because most people diagnosed with colon or rectal cancer have no family history of the disease. Also, most people don’t experience symptoms in the early stages of this type of cancer.

The good news is that a colonoscopy may not be your only option for screening. That’s where a FIT test – which stands for fecal immunochemical test – comes in.

Read on to learn more about what a FIT test is, how it works, and if it might be right for you.

What is a fecal immunochemical test (FIT)?

A FIT test is an annual stool test that screens for colorectal cancer. It’s convenient and done right at home.

The FIT test analyzes stool (or poop) for the presence of a specific type of blood that can be a sign of cancer. However, it’s important to know the test doesn’t diagnose colon or rectal cancer. Instead, a positive test signals that something could be going on and additional testing may be needed to make sure everything is okay.

Who is a candidate for a FIT test for colon cancer screening?

The latest guidelines from the United States Preventive Services Task Force and the American Cancer Society recommend colorectal cancer screenings begin at age 45 for all men and women.

Within that group, the best candidates for FIT tests are those who are at average risk for colon cancer. If you have certain risk factors, your primary care doctor may recommend that you start screenings sooner.

What is considered average risk for colon cancer?

You may be considered at average risk for colon cancer if:

  • You’ve never had a colonoscopy that found cancerous or precancerous polyps or tissues
  • You have no family history of colon cancer
  • You don’t have a hereditary colorectal cancer syndrome
  • You have no personal history of inflammatory bowel disease such as ulcerative colitis or Crohn’s disease
  • You haven’t received radiation to the belly or pelvic area to treat prior cancer

If you’re not sure about your individual risk factors or if a FIT test is the best screening option for you, talk with your primary care doctor.

Are FIT tests covered by insurance?

Most of the time, FIT tests are completely covered by insurance, even if you haven’t met your deductible. Since the recommended screening age was recently lowered, make sure to check with your insurance provider about coverage changes.

How does a FIT test work to screen for colon cancer?

Your colon is an important part of your digestive system, which works to process the food we eat and pull out food nutrients. Poop is what is left over after digestion is done. And since it travels through your entire digestive track, your stool can hold clues about what’s happening on the inside. What does your poop say about your health exactly? It can help you know if your digestive system is working correctly, if you may have food intolerances or if you have bleeding that may be a sign of cancer.

Most colorectal cancer occurs in growths, called polyps, which form on the lining of the colon. While not all polyps are cancerous, the ones with cancer – as well as those that are precancerous – are more likely to bleed. And that blood can end up in your stool.

How accurate is a FIT test?

No test is 100% accurate. With a FIT test, there’s a chance that a precancerous polyp or cancer can be missed if it wasn't bleeding when the test was done. That’s why regular screening gives you the best chance of cancer being found early, when treatment may be more successful.

What do FIT test results mean?

FIT test results don’t have a range. Once your test is complete, you’ll receive one of the following results:

  • Normal or negative results

  • A normal or negative result means there was no blood detected in the stool.

  • Abnormal or positive results

  • A positive FIT test means that there is bleeding in your digestive tract. With a positive test, there’s still only a small chance that you have colon cancer.

What happens after a positive FIT test?

If your FIT test is positive, your doctor will likely recommend a colonoscopy as the next step to identify what may be causing the bleeding. In addition to colon cancer, other conditions and diseases that a colonoscopy can detect include diverticulosis or diverticulitis, intestinal infections, ulcerative colitis and Crohn’s disease.

How often do you need to do a FIT test to screen for colon cancer?

FIT tests are done annually and for many, this will be the only colon cancer screening they’ll need for a given year. However, if your FIT test comes back positive for blood in your stool, your doctor will recommend a follow-up colonoscopy.

If you have a colonoscopy that finds cancerous or precancerous polyps, it’s likely that your doctor will recommend you stick with colonoscopies going forward. When you need your next colonoscopy will depend on the size and type of the polyps your doctor found during the procedure.

How do you prepare for a FIT test?

There’s really no preparation needed. All you need to do is call your clinic, let them know you’d like a FIT screening and the testing kit will be mailed to your home.

Because the test only reacts to a specific type of blood, there’s no need to change your diet or medications. But if you have bleeding due to your menstrual period or hemorrhoids, hold off on the test until you aren’t actively bleeding.

How do you do a FIT test?

You’re probably wondering what exactly the “FIT test procedure” involves.

A FIT test requires you to collect a sample of your stool and send it in for analysis. Don’t worry. You’ll receive step-by-step instructions with your testing kit. So, make sure to follow those directions when you’re ready to do the test.

Generally, this is a look at what you’ll need to do to collect your sample:

  1. Flush the toilet right before you need to poop.

  2. Have your bowel movement.

  3. Put your used toilet paper into the provided waste bag.

  4. Move the brush along the surface of the stool and then dip the brush into the toilet water.

  5. Touch the brush to the test card in the space indicated.

  6. Put the brush in the waste bag and then throw the bag away.

  7. Return the sample and requested information to the lab specified on your kit.

  8. Wait for your results, which you’ll receive within a week or so through a letter or online patient services.

It’s totally normal to feel a little squeamish about collecting the sample. But remember, everybody poops! Plus, you’re doing something important for your health.

Are there any risks with a FIT test?

Since the FIT test is noninvasive, the test itself doesn’t pose any risks. But it is possible to get a “false negative” result. This means that a precancerous or cancerous polyp can be present in the colon, but the test may still be negative.

An easier way to screen for colon and rectal cancer

There’s no question that colorectal cancer screenings save lives. And if you’re not jazzed about the prospect of a colonoscopy, a fecal immunochemical test can be a fast, easy way to check the health of your colon. At the end of the day, it’s not FIT test vs. colonoscopy. The important thing is that you get screened.

If you’re not sure when or if you need a screening test, talk with your primary care doctor or call your local clinic. They can help you choose when and how to screen for colorectal cancer.