As you might imagine, cancer screening tests are a frequent topic of conversation in my practice. And there’s one test in particular that is universally dreaded among my patients. Of course, I’m talking about colonoscopy.
Granted, there’s no shortage of risks with this procedure—from ruptured bowels to anesthesia. So I understand the hesitation many people feel. But the fact is, it is an effective screening tool.
Personally, I have an extensive family history of colon cancer. So I get a colonoscopy every three years… and I’ve survived each one. Which is why I continue to urge my patients to do the same—especially if they have a similar history and, therefore, higher risk.
That being said, I’m always on the lookout for less invasive, but equally effective, alternatives—like the fecal immunochemical test (FIT), which is what I want to talk about today.
Annual testing catches 95 percent of cancers
The FIT has been around for a while now—you might recall my first mention of it about five years ago. It’s a simple stool test you can perform at home. And it doesn’t require any uncomfortable or harsh preparations.
To recap, FIT is similar to the fecal occult blood test, another at-home procedure that tests for blood in the stool. But the fecal occult blood test only detects between 13 and 50 percent of cancers on the first screening. Not great accuracy—which is why I don’t wholeheartedly endorse it.
The FIT, however, is a different story. And research shows that if you use it annually, it can be a safe and effective colonoscopy alternative for adults with average risk of colorectal cancer.
A new meta-analysis looked at more than 30 studies—featuring more than 120,000 patients and FITs from 18 different companies—evaluating their sensitivity thresholds (which measures the likelihood of an FIT to accurately identify colorectal cancer—as opposed to a false-positive or false-negative).
The most accurate tests caught 95 percent of cancers, with a 10 percent false positive rate. Less accurate tests caught 75 percent of cancers, with a 5 percent rate of false positives.
In cases of advanced cancer, the test was much less accurate in general, making FIT a sensible option only for patients with lower risk profiles.
Do your homework
The U.S. Preventive Services Task Force (USPSTF) recommends colorectal cancer screening for patients over 50—whether it’s a colonoscopy (every three years) or yearly fecal occult blood testing. (FIT falls into the latter category.) They don’t recommend one test over another, but colonoscopies are generally considered the gold standard.
The issue is that only around 60 percent of the American population follows USPSTF guidelines and gets a colonoscopy when they should—most likely because of the fears I mentioned above. (Or sadly, due to lack of medical insurance coverage.)
And let’s be honest. American medicine isn’t the most exemplary when it comes to getting the best health care for the amount of money spent—especially where prevention is concerned.
Colonoscopies are expensive. And plenty of countries with better records in health care and spending use cheaper tests like FIT in low-risk patients, with excellent results. So ultimately, it’s a safe and viable option for you too—as long as you’re consistent with it.
Just keep in mind that there are more than 100 FDA-approved FITs on the market now. Some of them are cheaply manufactured and poorly tested.
So if you’re interested in FIT, please do a little research to ensure you’re getting a high-quality version. (The USPSTF website offers information on the most reliable FITs on the market.)
Another great option for average-risk patients hoping to bypass a colonoscopy is a test called Cologuard. This is another non-invasive, at-home screen that most insurance companies, including Medicare, will pay for.
At the end of the day, the most important thing is that you get screened—one way or another. Colorectal cancer is often a silent disease—one that, in many cases, doesn’t get caught until it’s already spread.
No one wants to be on the wrong end of those statistics. And with so many screening options available to you, odds are better than ever that you never will be.
P.S. If you or a loved one is suffering from a cancer diagnosis, you have a multitude of options outside of mainstream medicine’s “slash and burn” approach. In fact, I’ve created an entire online learning tool to help you navigate through the murky waters of cancer treatment.
“Noninvasive Stool Test Effective for Colon Cancer Screening.” Medscape Medical News, 02/26/2019. (medscape.com/viewarticle/909568)