Colorectal cancer is a serious and unfortunately often deadly disease. Early detection can increase the chances of survival drastically. However, many people avoid getting screened because they fear uncomfortable procedures such as colonoscopy. Well, you are in luck because FIT screening is an easy and effective option. FIT screening can be done at home, and has recently been confirmed as just as effective at preventing deaths from colon cancer as colonoscopy.
What is a Colon Anyway?
The colon is a part of your digestive system. Lined up behind the small intestines, the colon extracts nutrients and water from the partially digested food. What’s left becomes poop, which is stored in the rectum until release. Most people don’t think and don’t want to think much about this process, but once you get older than 45, it is advisable to turn your attention occasionally to this organ.
Why Should I Get Screened for Colorectal Cancer?
Colorectal cancer figures are shocking. In the US alone, about 153,000 people are diagnosed with colorectal cancer every year1.
With 53,000 patients dying each year, it is the third leading cause of cancer deaths in the US1,2. Many of these deaths, however, would be prevented if the cancer were detected early. Ninety percent of people diagnosed in early stages survive for at least five years3.
Early stage means that the cancer cells are only present in the colon or rectum. Once they spread to other organs that are further away like liver or lungs or distant lymph nodes3 chances of survival drop to 20%3.
Because early detection plays such a critical role in the outcome of colorectal cancer, the USA Centers for Disease Control and Prevention recommends starting regular screening from the age of 45 onwards, even earlier if members of your family had the disease4.
Will I have to have a colonoscopy?
In most cases, no! Most healthcare systems are adopting modern. Non invasive tests to screen for colorectal cancer.
We get it. Screening for colon cancer has the unfortunate reputation of relying on a medical procedure most may describe as the definition of discomfort: the colonoscopy. Being knocked out by a sedative so that a doctor can insert a tube into your most private opening to check for abnormalities does usually not rank very high on one’s bucket list. Suddenly the visit at the dentist for the long overdue root canal surgery sounds all right.
Now, I have some bad news and some good news. Let’s get the bad news out of the way: Having a colonoscopy every 10 years after turning 45 is and will stay highly recommended4. The good news is that other methods exist and those are a lot less scary. Fecal Immunochemical Test Screening (FIT Screening) is a highly effective and far less invasive method to check for early symptoms of colorectal cancer.
What is FIT screening?
FIT screening is easy. You get a kit sent to your home containing a toothpick sized plastic stick and container. With the stick you scrape a bit of your poop and then seal the stick in the container. Then you send the sample back to a laboratory, where it is analysed for small amounts of blood. Not only fully grown tumours but already precancerous polyps can bleed due to fragile blood vessels and potential inflammation around the abnormal tissue. The FIT test can detect small amounts of blood. If it comes back positive, doctors have to take a closer look.
To investigate whether regular FIT screening actually can reduce the number of cancer deaths, a team of physicians and scientists studied 11,000 people in the Kaiser Permanente Northern and Southern California health plan. Those individuals who had done at least one FIT screening in five years were 33% less likely to die from colon cancer. In different words: For every 25 people who do FIT screening, one person’s live is saved. Of course, FIT screening cannot prevent colon cancer but it allows to catch the disease early enough to prevent a lethal outcome. FIT screening works even better for cancers that are in the rear part of your colon. Asian, black and white ethnicities benefit most from FIT screening, while the benefit for Hispanics is unfortunately not so pronounced.
Why Should I Do a FIT screen?
FIT screening is an uncomplicated, cheap procedure you can perform in the comfort of your own home. It has, however, one disadvantage. It is very sensitive. It detects already minuscule amounts of blood. Blood in your stool does not mean you have colon cancer; it can have many other, harmless reasons. A FIT test will sound an alarm even if you don’t have colon cancer. The test is designed this way because it is better to have a false alarm and to do a double check than to miss a cancer.
In conclusion, FIT screening constitutes an easily applicable method to check for colon cancer that can be employed more frequently than invasive procedures like the colonoscopy. Because catching colon cancer early increases the chances of survival tremendously, the USA Center for Disease Control and Prevention recommends FIT screening once a year for all people 45 and older4. Talk to your doctor about it and get your test kit.
- Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024 Jan-Feb;74(1):12-49. doi: 10.3322/caac.21820. Epub 2024 Jan 17. Erratum in: CA Cancer J Clin. 2024 Mar-Apr;74(2):203. doi: 10.3322/caac.21830 PMID: 38230766.
- National Cancer Institute: https://www.cancer.gov/types/colorectal/patient/colorectal-screening-pdq
- American Cancer Society: https://www.cancer.org/cancer/types/colon-rectal-cancer/detection-diagnosis-staging/survival-rates.html
- USA Centers for Disease Control and Prevention: https://www.cdc.gov/colorectal-cancer/screening/index.html#:~:text=Screening%20recommendations,to%20your%20doctor%20about%20screening.
- Doubeni CA, Corley DA, Jensen CD, et al. Fecal Immunochemical Test Screening and Risk of Colorectal Cancer Death. JAMA Netw Open. 2024;7(7):e2423671. doi:10.1001/jamanetworkopen.2024.23671
