The word “colonoscopy” fills many folks with a sense of dread. If you’re in fear of undergoing this invasive procedure, you’ll be encouraged by study results from the Kaiser Permanente Center for Health Research in Portland, Oregon.
The study concluded that in-home tests requiring patients to collect a single stool sample, then send it to a lab for analysis, will detect a whopping 79 percent of colorectal cancers.
I had hoped these tests would be widely adopted – they’re so much simpler and cheaper than a colonoscopy and could be performed more often. But many people don’t use them or even know about them.
Read on for details…
The Centers for Disease Control and Prevention (CDC) lists colorectal cancer as Public Enemy #2 when it comes to cancer deaths. Only lung cancer claims more lives each year. In fact, lung cancer kills more than double the number of people than colon cancer does every year.
According to National Cancer Institute (NCI) statistics for 2023, about 153,000 people in the United States will be diagnosed with colon cancer—and nearly 53,000 people will die from it.
These cancer cells form in either the longest part of your large intestine (the colon) or in tissues of the large intestine closest to the anus (rectum).
When colorectal cancer spreads, abnormal cells are often found in nearby lymph nodes. From there, the cancer can spread to other lymph nodes or to organs such as the liver. The treatment methods for colon cancer aren’t pretty.
Surgery may involve simply removing polyps—or part of the colon, too. This can leave the patient needing a colostomy bag to collect wastes from the body.
And you should know that chemotherapy drugs for advancing colorectal cancer can cause the skin on your palms and the bottoms of your feet to become red and painful. It may even peel off! Radiation treatment also has multiple downsides. It can cause bloody stools…diarrhea… nausea and vomiting… and urgent bowel movements.
Taking a simple, at-home test as an early detection measure starts to sound pretty attractive, right?
Keeping your colon FIT
FIT stands for the fecal immunochemical test which offers a number of different varieties for at-home testing. The Kaiser Permanente team reviewed 19 studies including eight of the varieties.
The researchers found that all eight FIT tests were fairly sensitive and accurate predictors of colon cancer. And this was true even though most FITs only required one stool sample. In fact, the authors were surprised to find that FIT tests requiring two or three stool samples were no more accurate than those requiring only one.
Here are some of the important study details:
- Researchers examined 19 studies that included between 80 and 27,860 patients.
- Participants’ ages ranged from 45 to 63, and none of them showed any signs of colorectal cancer at test time.
- Patients in 12 studies took the FIT and received a colonoscopy as well; patients in seven studies only had a colonoscopy if their FIT results were positive (i.e. indicated cancer).
Approximately two years later, researchers followed up with patients who had had a negative FIT to determine whether they had been diagnosed with colorectal cancer. The researchers found that in-home tests requiring patients to collect a single stool sample, then send it to a lab for analysis, will detect about 79 percent of colorectal cancers.
These results were encouraging when compared with an older type of at-home FIT test known as the fecal occult blood test (FOBT) which is not very accurate. A single round of testing flags only about 13 percent to 50 percent of cancers.
Plus, the FOBT requires three stool samples in tandem with medication and dietary restrictions prior to the test. The FIT test does NOT require people to stop their medications or restrict their diets. And there’s certainly no need for the uncomfortable prep required before a colonoscopy.
In a Kaiser press statement, lead study author Jeffrey Lee, MD, MAS concluded “FIT is simple, can be done at home, and can save lives. The American Cancer Society and other professional organizations have recommended FIT as a screening tool for colorectal cancer since 2008, but there are still many people who don’t know about it.”
So, how can you know whether you’re at risk?
Basically, you should talk to your doctor if you experience a change in bowel habits. This includes finding blood in your stool or stools that are narrower than usual.
Other symptoms may include diarrhea or constipation, frequent gas pains, bloating or cramps, weight loss for no reason, or a feeling that your bowel does not empty completely.
Unfortunately, many symptoms of colon cancer don’t appear until after the cancer has spread, earning this dreadful disease its nickname, the “silent killer.” That’s why simple, affordable, at-home tests like the FIT test are so important.
Who should get the FIT test
The FIT test is recommended as an annual screening test for everyone aged 50 to 74 at average risk for colon cancer, that means there’s no personal or family history of colorectal cancer. If you have an increased risk, a colonoscopy is recommended.
The National Cancer Institute lists these risk factors for colon cancer which include if you’re:
- Age 50 or older: More than 90 percent of people with this disease are diagnosed after age 50. The average age at diagnosis is 72.
- Suffering from colorectal polyps: These growths on the inner wall of the colon or rectum are common in people 50 and older. Most polyps are not cancerous but some can develop into cancer. Finding and removing polyps may reduce colorectal cancer risk.
- In a family with a history of colorectal cancer: Close relatives of a person with colorectal cancer are somewhat more likely to develop this disease themselves, especially if the relative had the cancer at a young age. In my view this is more likely because of shared eating habits or toxin exposure rather than genes.
- Suffering or have suffered from certain cancers: A person who has already had colorectal cancer may develop colorectal cancer a second time. Also, women with a history of cancer of the ovary, uterus (endometrium), or breast are at a somewhat higher risk of developing colorectal cancer.
- Suffering with ulcerative colitis or Crohn’s disease: These conditions can lead to inflammation of the colon for many years; this can increase risk of developing colorectal cancer.
- A cigarette smoker: May increase the risk of developing polyps and colorectal cancer.
- Eating a fiber-poor diet: High-fat, low-fiber diets may increase the risk of colorectal cancer.
The list omits what I would consider to be far and away the most important cause of colon cancer: a diet low in fresh fruits and vegetables, high in sugar and refined carbohydrates (including alcohol), and high in processed and packaged foods.
How to get a FIT test
For many years FIT tests were only available by prescription. But now you can get them over-the-counter or through your doctor’s office. The costs have come down dramatically with some kits available for as little as $50. In many cases, you can buy the test yourself, send the sample to the lab and receive results yourself without having a doctor in the loop.
National Cancer Institute. 2023. factsheet. Available online
https://seer.cancer.gov/statfacts/html/common.html#:~:text=Lung and bronchus
cancer is responsible for the most deaths,deadliest cancer
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Lee, J.K. et al. 2014. Accuracy of fecal immunochemical tests for colorectal cancer: Systematic review and meta-analysis. Annals of Internal Medicine. Abstract available at http://annals.org/article.aspx?articleid=1819122