Have you heard of FIT? Colorectal cancer screening might be easier than you thought

In February, 2017, Berkeley Wellness published the article A Good FIT for Colorectal Cancer Screening featuring an interview with James Allison, M.D., a renowned expert on colorectal cancer (CRC) screening tests. Many people know about the colonoscopy, but what about the less invasive recommended screening for average-risk individuals called the fecal immunochemical test (FIT)?

FIT is an at-home stool test that is cheap, covered by all insurance, and “has been shown to be equally effective as colonoscopy every 10 years [for average-risk patients],” said Dr. Allison. “As a general rule, I encourage my average-risk patients to go from least invasive to most invasive screening tests.” FIT-based screening is recommended yearly for patients who are 50 and older with an average risk of colorectal cancer.

Two types of FIT are recommended by the latest U.S. Preventive Services Task Force’s CRC Screening Guidelines: OC-Light and the OC-Auto FIT tests. “The CDC uses these guidelines for their FIT recommendations to state Departments of Public Health. Other…FIT tests may not have proof of their performance characteristics…in large average-risk populations,” said Dr. Allison.

Since 2012, the medical community has moved away from the one size fits all approach to CRC screening. Randomized control trials have shown important results for annual FIT tests and “are believed to decrease the incidence and mortality from CRC.”

Here are some important topics to discuss with your doctor when learning more about FIT:

  • “Is the FIT you recommend among those [from the] latest U.S. Preventive Services Task Force’s CRC Screening Guidelines?” (OC-Light and the OC-Auto FIT tests)
  • "Where do I get the test?" (lab or drugstore from a doctor's order)
  • "Where do I mail my completed FIT kit?" (health plan's lab or the lab recommended by physician)
  • "Will the test results be sent to both my primary care provider and me?" 

And here’s what will happen once you receive the FIT from the lab or drugstore:

  • Following the kit guidelines, prepare one simple stool test from the comfort of your home.
  • Mail in the test to the appropriate lab. 
  • Wait for results. 

Finally here is what to expect once you receive the results of your FIT:

  • If the results are negative, you do not need to do anything else except to schedule another FIT test in a year. If you do not go to an organized health care center that has methods for reminding patients and primary care providers about the annual FIT, Dr. Allison advises “to…ask your doctor for a FIT test when you come in for your annual flu shot.”
  • If the results are positive, discuss options with your primary care provider. A positive FIT should ALWAYS be followed by a colonoscopy.

“The test you select for screening is an individual choice,” said Allison. “The CRC screening tests with the best record and the most data behind them are FIT and colonoscopy. A FIT-based screening program is the most cost effective.”

Cancer prevention starts with you. Talk to your doctor about colorectal cancer screening including FIT. 

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Maine Cancer Foundation is proud to support colorectal cancer screening efforts in Maine. Here are the latest programs we fund.

Read Dr. Allison’s full interview

U.S. Preventive Services Task Force’s CRC Screening Guidelines

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Thursday, March 16, 2017