A non-invasive fecal immunochemical test done entirely at home can cut colorectal cancer deaths by 50% among adults aged 50 to 69, according to a 21-year study from Spain examining data from 2.2 million people. Colorectal cancer is the second most common cause of cancer deaths in men and women, with screening rates climbing among adults aged 50 to 64 who often avoid traditional procedures due to fear, inconvenience, or the infamous bowel-cleansing prep.
How FIT Home Testing Works Without Prep or Laxatives
Unlike colonoscopies, the fecal immunochemical test requires no fasting, anesthesia, or harsh laxative solutions to flush the bowels. According to Dr. Alexis Grucela, a colorectal surgeon at Northwell Northern Westchester Hospital, the test is quick and simple for patients. There is no disruption to normal eating, drinking, or medication routines. Users simply order a kit, collect a stool sample at home, and return the container to a lab for testing, often through the mail.
Did you know? While colonoscopies are recommended every 10 years for average-risk adults, tests that detect blood in the stool such as FIT and gFOBT are typically recommended annually.
Comparing FIT, Cologuard, and Traditional Colonoscopies
An FIT specifically looks for blood in the stool as a sign of colon cancer. Compared to multitarget stool DNA tests like Cologuard, an FIT is less costly and does not require insurance approval or authorization, making it widely accessible through primary care doctors, nurses, physician assistants, or direct lab service orders.
Another alternative, the gFOBT test, also detects blood in the stool but requires certain foods and medicines to be avoided alongside samples from three bowel movements in a row. According to the Mayo Clinic, the FIT finds cancer, polyps, and advanced adenomas better than the gFOBT and delivers fewer false positives. However, DNA tests like Cologuard identify advanced lesions more effectively and are recommended every three years rather than annually.
When a Colonoscopy Remains the Gold Standard
An FIT serves as a screening tool rather than a diagnostic procedure or a direct replacement for a colonoscopy. If an FIT returns a positive result, patients must undergo a colonoscopy. While an FIT costs less than $100 out of pocket, colonoscopies can cost thousands of dollars without insurance and require specialized doctors.
Furthermore, colonoscopies perform a dual function by both biopsying suspicious masses and actively removing precancerous polyps to prevent cancer. Patients experiencing active symptoms like abdominal pain or changes in bowel habits, or those with a risk of colorectal cancer because of family history, should choose a colonoscopy, according to clinical guidance.
Frequently Asked Questions
Can I order a fecal immunochemical test without visiting a doctor?
Yes. While primary care doctors, nurses, and physician assistants can order an FIT, individuals can also order the kit directly through lab services without scheduling a doctor’s visit.
Does an FIT require any dietary changes?
No. Unlike older stool tests that require avoiding certain foods and medications, the FIT requires no prep, fasting, or medication changes.
What happens if my home test comes back positive?
A positive FIT indicates the presence of blood in the stool, which requires a follow-up colonoscopy so a physician can investigate further and determine if cancer or polyps are present.
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