Could A Simple At-Home Test Simplify Colorectal Cancer Detection?

A brand new, and very simple, at home screening test could be as effective at detecting colorectal cancer as a full colonoscopy.

This new screening test is called the fecal immunochemical test, or FIT. This test works by determining if there is blood present in a stool sample; blood that would not be visible at first sight.  Blood in stool, of course, does not necessarily imply the presence of a colon polyp—as it can signify a wide variety of health conditions.  However, blood in stool (particularly trace amounts) can be an early sign of a developing colon polyp.  

Colon polyps are small growths that are typically not cancerous.  However, their presence could mean a higher risk for cancer. And this new study says that the very simple fecal immunochemical test could act as a practical pre-screening test. 

Lead study author Thomas Imperiale, MD, explains, “Our analysis finds that FIT is a good ‘pre-screening’ test for average risk, asymptomatic adults, saving them hassle and the U.S. healthcare system costs.”  

The term “average risk” implies that a person does not have a family history for the disease and does not have inflammatory bowel disease or existing colon polyps.  However, the recommendation is that anyone who might be at risk should perform a FIT every year, compared against a colonoscopy, which is only advised about once every ten years. 

The Indiana University School of Medicine gastroenterologist is also a research scientist with the Regenstrief Institute. He goes on to say, “If annual FIT results remain negative, FIT buys you time until colonoscopy may be required, and it could be the case that a colonoscopy for screening may never be necessary or required.”

Furthermore, Imperiale attests that we need a population-based system with “better laboratory-physician coordination, dedicated follow-up, and assurance that colonoscopy is performed if FIT results are positive.”  

Indeed, FIT’s efficacy lies within its repeat application. Imperiale assures that FIT had a sensitivity between 75 and 80 percent; or, rather, that is the success rate by which FIT can actually identify cancer among those who had the disease.  By comparison, a full colonoscopy has a sensitivity (probability for identifying cancer) of 95 percent.

Currently, the United States Preventive Services Task Force recommends colorectal screenings—by way of fecal occult blood testing (including FIT, and many others)—from age 50 to 75.  

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