What Is a FIT Test, and Which Ones Are Best to Use?

• Best affordable at-home test: Everlywell FIT Colon Cancer Screening Test | Skip to review
• Best FIT test with 24-7 support: LetsGetChecked At-Home Colon Cancer Screening | Skip to review
• Best for simpler sample collection: LabCorp Colorectal Cancer At-Home Test | Skip to review
• Best for instant results: Pinnacle Biolabs Second Generation FIT | Skip to review
• Best with DNA testing: Cologuard | Skip to review

This article explains what a FIT test involves, looks at the advantages and disadvantages of different at-home tests and answers some frequently asked questions.

A FIT test screens for colorectal cancer by checking for blood in the stool. FIT stands for fecal immunochemical test. It is one of the two main types of fecal occult blood tests.

Blood vessels in colon tumors or polyps may bleed with the passage of stool, but the blood is not always visible to the naked eye. Invisible blood is also known as occult blood. A FIT test uses antibodies to detect this hidden blood in the stool.

What does a positive FIT result mean?

The detection of blood indicates a positive test, but it does not necessarily mean a person has colorectal cancer. Other conditions, such as hemorrhoids, benign polyps, and ulcers, may also cause blood in the stool. However, a positive test indicates that an individual should contact a doctor for additional tests, such as a colonoscopy.

How to take a FIT test

The FIT test is a simple and noninvasive test that people can perform at home. A home testing kit will include instructions and a sterile container for the stool sample. Most kits will also include an envelope for mailing the sample to a laboratory. A person does not have to restrict their diet or specially prepare before collecting their sample.

Some people may wish to perform a FIT test as routine screening due to age. The Preventive Services Task Force recommends that adults ages 45–75 years undergo screening for colorectal cancer.

Other individuals may wish to undergo testing because they are experiencing symptoms that could indicate colorectal cancer. These include:

• unexplained abdominal pain
• blood in or on the stool
• a feeling that the bowel is not empty after a bowel movement
• changes in bowel habits, including diarrhea or constipation
• unexplained weight loss

The concept behind a FIT test is the same regardless of the manufacturer, although individual instructions and processing times may vary. Below are several home testing kits to consider.

Please note that the writer of this article has not tried these products. All information presented is purely research-based and correct at the time of publication.

The following table compares the FIT tests in this article.

People may wish to consider the following when purchasing an at-home test:

• Results turnaround: Testing companies often provide results within a week. People who are looking for faster test results may prefer to purchase a product with a shorter turnaround time and check whether ordering online offers the quickest turnaround.
• Insurance: Many at-home test companies do not accept insurance. People may wish to consider whether it would be less expensive to purchase a test out of pocket or go through a doctor’s office and claim it on their insurance.
• Accessibility: Most at-home tests are available through the manufacturer’s website. However, some tests, such as Cologuard, require people to either request a test through a doctor or attend a telemedicine appointment.
• Price: At-home test prices vary but are often between $30 and $90.

A FIT test involves collecting a stool sample and sending it off to a lab for analysis. No special diet or other prep is needed. A FIT test is unlikely to feel any more uncomfortable than making any other bowel movement.

However, collecting a stool sample is often a new experience for testers and it can feel challenging. Each brand will have its own process, so people will need to follow instructions carefully.

They typically involve:

1. Securing collection paper across the toilet bowl rim.
2. Making a bowel movement onto the collection paper.
3. Inserting an applicator into the stool in different places.
4. Securing the applicator in a sample collection tube.
5. Putting the sample collection tube in a specimen pouch and mailing the package to a lab, usually in a pre-addressed, prepaid envelope.

In the United States, colorectal cancer is the fourth most common cancer in males and females and the fourth leading cause of cancer-related deaths in the U.S.

Although anyone can develop this type of cancer, risk factors include:

• having excess body weight or obesity
• living a sedentary lifestyle
• eating a diet low in fruit and vegetables
• eating a low fiber and high fat diet
• consuming large quantities of processed meats
• smoking
• drinking alcohol

Colorectal cancer tends to grow slowly, and detecting precancerous polyps or small lesions helps improve the outlook. Colorectal cancer screening tests, such as a FIT test and a colonoscopy, make early diagnosis possible.

Whether an individual has a colonoscopy or FIT test may depend on their assessed risk. The American Cancer Society (ACS) defines average risk as:

• no history of colorectal cancer or polyps
• no family history of colorectal cancer
• no history of Crohn’s disease or any form of inflammatory bowel disease
• no history of hereditary colorectal cancer syndrome
• no history of radiation treatment to the belly

Anyone who receives a positive FIT test result should contact a doctor for further evaluation. Although a positive test does not necessarily mean a person has colorectal cancer, a healthcare professional can discuss the next steps.

It is also important to contact a doctor if symptoms occur that could indicate colorectal cancer. People who believe they have an increased risk of this disease may also wish to discuss regular screening with a healthcare professional.

Below, we answer some of the most common questions about FIT tests.

Is a FIT test accurate?

Overall, a 2020 meta-analysis of 44 studies found that FITs detected four out of five cases of colorectal cancer at stages II through IV. However, the sensitivity of the test was lowest for the earliest stages of this cancer, and detecting colorectal cancer as early as possible is significant.

When should you take an at-home colorectal cancer test?

The U.S. Preventive Services Task Force recommends that adults without signs or symptoms of colorectal cancer with average risk undergo routine screening for colorectal cancer from age 45 to 75.

The American Cancer Society recommends the same time frame for colorectal cancer screening for people with average risk. An annual FIT test could meet this standard for this population.

If a person wishes to have a FIT test instead of other screening options, they can discuss this with their doctor.

Can a FIT test diagnose colorectal cancer without a colonoscopy?

A FIT test does not diagnose colorectal cancer. Instead, it detects blood in the stool, which is not always visible to the naked eye. The presence of blood may indicate colorectal cancer or other bowel complications. A positive FIT result warrants further investigation to diagnose the cause of the bleeding.

Does insurance cover a FIT test?

Whether a person’s insurance covers a FIT test may depend on their age and specific benefit package. For example, Medicare covers the test once every 12 months for enrollees ages 45 years and older.

In some cases, an individual may also use funds from their HSA to cover the costs.

Is a FIT test as good as Cologuard?

Cologuard tests for atypical DNA in addition to blood, and some may consider this screening more thorough. However, a small 2020 study showed that Cologuard returned a 13.4% false-positive result rate — 8.3% higher than the FIT test method.

What does a positive FIT result mean?

A positive result means that there was blood within the stool — possibly not visible to the naked eye — at the time of testing.

If a person’s result is positive, they should contact a doctor, who may then recommend a colonoscopy.

What can a FIT test detect?

A FIT test can detect early signs of colon cancer, but there are other reasons an individual may receive a positive result, including:

• colon polyps
• precancerous polyps
• inflammation
• hemorrhoids

Seeking medical advice is important in excluding or diagnosing any medical condition.

What are other names for a FIT test?

A FIT test is also known as a fecal immunochemical test or an immunoassay fecal occult blood test (iFOBT), which looks for hidden blood in stool with antibodies that bind to blood protein.

Similar tests include the guaiac-based fecal occult blood test (gFOBT), which uses a chemical called guaiac to detect blood in stool, and FIT-DNA, which combines a FIT test with a test that looks for altered DNA in a person’s stool.

Is a FIT test as good as a colonoscopy?

The Colorectal Cancer Alliance describes a colonoscopy as the gold standard in colorectal cancer screening and the most complete screening tool currently available. Additionally, physicians can detect and remove polyps during a colonoscopy, making the procedure preventive as well as diagnostic.

However, the FIT does have some advantages over a colonoscopy. It does not require any preparation, is less invasive, and is far quicker to complete.

People can discuss which option is best for them with a doctor.

A FIT test is a type of colorectal cancer screening. The test detects blood in the stool that may not be visible to the naked eye. The presence of blood indicates a need for further screenings to diagnose the cause of the bleeding. While a positive result does not necessarily mean a person has cancer, early detection and treatment of this disease generally improve their outlook.

A variety of at-home FIT test kit options are available for people to consider. Individuals can perform these tests at home, often without needing a doctor’s visit.