Not Up For Colonoscopy? I Got You.

Many of my patients have not had colorectal cancer screening.

Even though such screening reduces the risk of dying of the disease, many point to the unpleasantness of a colonoscopy preparation (cleanout) as the reason.

I am coming to the view that while colonoscopy is the gold standard, it is expensive and unwieldy.

A young Asian man stands with a thumbs-up sign. — Photo by Afif Ramdhasuma on Unsplash

Now, I simply want to increase the suboptimal screening rate.

A new study also reminds us that simpler colorectal screening tests save lives.

What is FIT?

It’s a fecal immunochemical test, a simple and convenient screening test for colorectal cancer that you can easily perform in the comfort of your home.

It checks for hidden (occult) blood in the stool, which can be an early sign of cancer.

Here’s how it works:

Sample collection: A small stool sample is collected at home using a special kit.
Testing: The sample goes to a lab, where it’s tested for the presence of blood using antibodies that specifically detect human hemoglobin.
Results: A positive result indicates the presence of blood, possibly due to cancer, polyps, or other conditions. A negative result means the test discovered no blood.

FIT Test Summary

In summary, FIT is a non-invasive, easy-to-use test that can be done annually (for those at average colorectal cancer risk).

The FIT test is more accurate and has fewer false positives than other stool-based tests.

However, it’s important to note that FIT is a screening test, not a diagnostic one.

A screening test detects potential health problems in people without symptoms, while a diagnostic test confirms the presence of a disease or condition in someone with symptoms.

A positive result requires further testing, such as a colonoscopy, to confirm the presence of cancer or other issues. This follow-up testing is crucial for accurate diagnosis and timely treatment.

Study Results

A groundbreaking study reveals that individuals who underwent at least one fecal immunochemical test (FIT) screening experienced a significant decrease in their risk of dying from colorectal adenocarcinoma.

Most of the control group (64 percent) underwent at least one FIT screening within ten years before the reference date.
The cumulative positive FIT result rate was 13 percent.
A significant proportion (79 percent) of those with positive results received a colonoscopy within a year.
In the five years preceding the reference date, FIT screening rates were lower, with 45 percent of cases and 56 percent of controls undergoing at least one test.

FIT and Mortality Risk

The results are impressive:

Completing one or more FIT screenings was associated with a substantial one-third reduction in overall colorectal cancer mortality risk.
The risk reduction was even more pronounced for cancers in the left colon and rectum, with a 42 percent relative decrease.
There was no statistically significant impact on right colon cancer mortality.

Impact by Race/Ethnicity

The impact of FIT testing varied by race and ethnicity:

Asian patients: 63 percent reduction
Black patients: 42 percent reduction
White patients: 29 percent reduction
The 22 percent risk reduction observed in Hispanic or Latino patients was not statistically significant.

Key Takeaways – Not Up For Colonoscopy? I Got You.

The researchers found these encouraging results:

Fecal immunochemical test screening led to a one-third drop in mortality. FIT testing was associated with a more substantial 42 percent relative decrease for cancers in the left colon and rectum.

FIT screening demonstrates a significant ability to reduce CRC mortality, particularly for left colon and rectal cancers.
The impact of FIT screening is evident across various racial/ethnic groups.
The study underscores the importance of FIT screening as a valuable tool in CRC prevention and early detection.

My Final Thoughts – Not Up For Colonoscopy? I Got You.

I am delighted that this research supports broadening how many think about colorectal cancer screening.

With the coordinated delivery of FIT screening and timely follow-up of concerning results, we can prevent many premature deaths caused by colon and rectal cancer.

Have you had colorectal screening?

If yes, what type? Colonoscopy? FIT? Cologuard? Other?

Finally, here are colorectal screening recommendations:

Colorectal Cancer: Screening
www.uspreventiveservicestaskforce.org

Cologuard® Test vs FIT | Cologuard® For HCPs
The Cologuard® test detects 11 distinct biomarkers and demonstrated superior sensitivity vs FIT in detecting colorectal…www.cologuardhcp.com

Thank you for reading “Not Up For Colonoscopy? I Got You.”

Does Colonoscopy Work?