Colorectal cancer CRC is the second most common cancer affecting men and women. Fortunately, though, it is highly preventable if individuals over age 50 undergo screening. There are several CRC screening tests from which to choose. Non-invasive tests analyze a stool sample for occult blood, which include the so-called fecal occult blood test FOBT and fecal immunochemical test FIT. Other tests employ structural imaging of the colon by endoscopy colonoscopy, sigmoidoscopy. Both of these have been shown to reduce deaths from CRC.
But with choice comes some confusion as to which test to do. Over the past decade, colonoscopy and FIT have become the most widely used. Colonoscopy is often considered the best test because: 1 it can both detect and remove cancerous and precancerous polyps; 2 it misses very few cancers or polyps; 3 if normal, it does not have be repeated for 10 years sooner if polyps are found , and 4 it is covered by most insurances.
No wonder colonoscopy is often preferred by many physicians and patients. Ideally, a cancer screening test should be non-invasive, easy to perform, safe, operator- independent, inexpensive, and accurate. FIT testing has most of these advantages.
It is non-invasive, performed at home on a single stool sample, inexpensive, and operator-independent. As such, FIT should be repeated every year, something that most patients and their physicians find hard to do, or keep track of.
Even when this is done, the nature of bleeding by colon cancers and polyps is such that those located in the distal colon close to the rectum are detected better than those in the proximal colon further in from the rectum.
