Is a FIT test as good as a colonoscopy?

Colorectal cancer starts in the colon or the rectum and is the third most common cancer worldwide. The American Cancer Society estimates that there will be 106,970 new cases of colon cancer and 46,050 new cases of rectal cancer in the United States in 2023. 

Thanks to more regular screening and lifestyle changes, the rate of people being diagnosed with colon or rectal cancer has decreased over time. Physicians can screen for and remove colorectal polyps before they can develop into cancers. The two most common screening tests are a colonoscopy and a FIT (fecal immunochemical test). In this article, we will explore when each test is appropriate and how both can reduce the risk of colorectal cancer. 

What is a FIT test?

A FIT test is a non-invasive screening test that checks for human blood from the lower intestines in the stool, which can be a sign of colorectal cancer or other gastrointestinal problems. The test is performed at home by collecting a small stool sample and sending it to a laboratory for analysis. FIT tests are recommended for people between the ages of 50 and 74 who are at average risk of colorectal cancer and do not have any symptoms. A FIT test can be performed at home by a patient.

Schedule a time to chat with us about at-home FIT testing through the Ash Platform.

What is a colonoscopy?

A colonoscopy is an invasive screening test that uses a long, flexible tube with a camera and light at the end to examine the entire colon and rectum for abnormalities. If a physician spots an abnormality, it is removed (biopsied) and tested for cancer. While screening is performed on people without symptoms, patients with targeted problems in the colon or rectum might also undergo a colonoscopy at the recommendation of a physician. 

Is a FIT test as good as a colonoscopy?

While a colonoscopy is the gold standard for screening colorectal cancer, a FIT test breaks down barriers to care, such privacy considerations and aversion to intrusive medical procedures. A colonoscopy can detect cancer at an earlier stage when it is more treatable and can also prevent cancer by removing polyps before they have a chance to turn into cancer. A FIT test, on the other hand, only detects blood in the stool and does not provide any information about the location or cause of the bleeding. 

That said, physicians often use a FIT to determine if patients need to come into the office for a full colonoscopy. For patients of average risk, studies show that FIT is a good alternative for a colonoscopy. 30% of adults skip screening altogether, and there is evidence that those people will complete a FIT test rather than a colonoscopy. 

Many people put elective procedures such as a colonoscopy on hold during the COVID-19 pandemic, which resulted in fewer screenings. Physicians fear that this delay will result in fewer colorectal diagnoses in the future, which highlights the importance of alternate screening options. 

What are the risks of a colonoscopy? 

A colonoscopy is an invasive procedure that requires sedation and can cause complications such as bleeding, perforation of the colon, and infection. In rare cases, complications from colonoscopy can be life-threatening. Patients should discuss the risks and benefits of colonoscopy with their physician and make an informed decision about whether to undergo the procedure.

Conclusion: 

While a FIT test is a good screening test for colorectal cancer, it is not as effective as a colonoscopy in detecting and preventing the disease. Colonoscopy is the only test that can both detect and prevent colorectal cancer, and it is associated with a significant reduction in colorectal cancer mortality. However, FIT testing may be a good choice for screening large swaths of the population as well as average risk patients. 

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