This Colonoscopy is a Right FIT

FIT colonoscopy cheaper and more effective than gFOBT for diagnosing colon cancer

(RxWiki News) Getting a colonoscopy is an important diagnostic decision. New research has helped indicate what type of colonoscopy may be right for you.

According to researchers, Fecal immunochemical testing (FIT) is cheaper and more effective than guaiac fecal occult blood testing (gFOBT) for screening for colon cancer. This could lead to improvements in diagnosing and treating colon cancer.

"Ask your doctor about the best type of colonoscopy for you."

Researchers from the University Medical Center in Rotterdam ran simulations of large populations that compared FIT and gFOBT based on cost, health effects and number of procedures performed. Using predicted statistics, it was determined that FIT was cheaper and is clinically effective in detecting colon cancer.

According to the model, the best health benefits based on cost involved patients aged 45 to 80 in an area where an unlimited amount of colonoscopies could be performed, like in a big city. The model used an agressive FIT screening method and the lowest accepted standard that would require further testing using a colonoscopy. 

For patients who could only undergo a limited number of colonscopies, a higher standard was needed, but FIT still performed better than gFOBT.

Their simulation did not account for all possible factors, including how the amount of colonoscopies can affect an individual. Statistical models can be good to predict possible outcomes, but the biggest flaw is that they cannot account for human response to possible side effects, according to Russell Harris, M.D., MPH, of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill and Linda S. Kinsinger, M.D., MPH, of the Department of Health Behavior and Health Education at the University of North Carolina School of Public Health.

Things like anxiety, over-diagnosis, loss of productivity and risks for complications cannot be weighed in the simulation. For Drs. Harris and Kinsinger, more testing and results are needed for comparison so it can be determined if an aggressive approach to screenings is actually beneficial to the patient.

The results determined FIT is a better choice than gFOBT. Researchers did not rule out using gFOBT if the number of colonoscopies that can be performed in an area was increased.

Finding methods that are convenient and affordable to a patient is a priority for future research. 

This study was published in the November edition of the Journal of the National Cancer Institute.

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Review Date: 
November 9, 2011