FIT: A New Way to Screen for Colon Cancer

Colorectal cancer may be effectively diagnosed with fecal immunochemical test

(RxWiki News) Screening for colorectal cancer may have just gotten a whole lot easier.

In a new study, researchers from Kaiser Permanente found that the fecal immunochemical test (FIT) could effectively detect colorectal cancer and also had a high adherence to recommended yearly follow-up testing among patients — making the non-invasive stool test an easy and affordable screening option.

This is significant given that colorectal cancer is the second leading cause of cancer death in the US. Despite its prevalence, 1 in 3 US adults is not adequately screened for the disease, according to the Centers for Disease Control and Prevention (CDC).

"FIT has the benefit of being done every year, so we can detect cancers that start growing in-between tests," said study author Douglas A. Corley, MD, a gastroenterologist at Kaiser, in a press release.

Unlike other stool tests, FIT can be completed entirely by mail and does not require any dietary or medication restrictions. The test works by detecting small amounts of blood in the stool and can find most colorectal cancers before any symptoms occur.

For this study, Dr. Corley and team mailed 670,000 FIT kits to eligible members of Kaiser Permanente between 2007 and 2013. Of those patients, more than 323,000 completed a fecal test within one year.

The test found colorectal cancer in more than 80 percent of the patients in the first year, and up to 78 percent in the next three years of screening.

More than 75 percent of patients who began screening with FIT also repeated the test in subsequent years. Of the patients with positive FIT tests, nearly 80 percent underwent the recommended follow-up colonoscopy. Ninety-seven percent underwent either a colonoscopy or another screening test.

"We don’t have evidence that one colorectal cancer screening test is better than another; each has its advantages and disadvantages," said study co-author Theodore R. Levin, MD, in the press release. "The most important thing is that people get screened."

The US Preventive Services Task Force (USPSTF) recommends that patients with average risk of colorectal cancer get screened between ages 50 and 75.

There are multiple screening methods for colorectal cancer available, including colonoscopies, which use a camera to look at the colon and are recommended every 10 years. Patients can also undergo a sigmoidoscopy, which examines the lower colon and is recommended every five years.

The current screening rate for colorectal cancer at Kaiser Permanente is more than 80 percent. Although all screening methods are available to members, FIT and colonoscopy are the most commonly used tests.

This study was published Jan. 25 in the journal Annals of Internal Medicine.

The National Cancer Institute funded this research. No conflicts of interest were disclosed.

Review Date: 
January 27, 2016