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A fecal immunochemical test (FIT) is a diagnostic tool that helps screen for colorectal cancer by detecting hidden blood in the stool. The best tests use CLIA-certified labs and provide results quickly.

In the United States, colorectal cancer is the fourth most common cancer and the fourth leading cause of cancer-related deaths.

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.

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.

Learn more about colorectal cancer.

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:

Who is average risk?

The American Cancer Society (ACS) recommends that people of average risk of colorectal cancer begin regular screening at the age of 45 years through to 75. Healthcare professionals will help people ages 76–85 years determine a screening schedule based on prior results, health, and life expectancy.

The ACS defines average risk as:

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

  • having a personal or family history of colorectal cancer or colorectal polyps
  • having IBS
  • having hereditary colorectal cancer syndromes
  • having obesity or overweight
  • irregular physical activity
  • drinking alcohol
  • smoking
  • eating a less nutritious diet

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.

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

However, collecting a stool sample is often a new experience for testers and 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.

According to 2020 research, FIT tests have a high accuracy rate for diagnosing colorectal cancer.

Further research from 2021 suggests that a positive FIT result is better than symptoms when determining which individuals require urgent investigation.

However, according to a 2018 systematic review and meta-analysis, some risk factors can cause a false positive or false negative FIT result. This could result in a delayed colorectal cancer diagnosis for those with a false negative or an unnecessary colonoscopy for individuals with a false positive.

This research says those who are at an increased risk of a false positive or false negative FIT result include those who:

What do the results 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.

If the test is negative, this means the test did not find any blood in the stool. However, a test may occasionally miss the blood or polyps that would indicate colorectal cancer. Healthcare professionals may order another test if a person is still experiencing symptoms.

An inconclusive test result can mean a person incorrectly collected a sample or there was an issue when the lab tried to test it. As healthcare professionals cannot determine a negative or positive test result, a person will need to repeat the test.

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.

Medical News Today’s methodology

Medical News Today chooses at-home tests that meet the following criteria:

  • Laboratories: Where possible, MNT selects companies that process test samples in CLIA-certified labs. This means they follow state and federal regulations.
  • Budget: MNT chooses at-home tests that suit a wide range of budgets.
  • Privacy: MNT includes companies that offer robust and transparent privacy measures, such as data protection and discreet packaging.
  • Test result speed: MNT selects companies that inform customers when they will receive their test results and whether they will receive them via email, app, or phone.
  • Further support: MNT will indicate whether a company offers further support, such as a follow-up phone consultation with a doctor to discuss test results.

Medical News Today follows a strict product selection and vetting process. Learn more here.

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FIT tests are available via a healthcare professional. However, several companies offer at-home testing that may be more convenient, faster, and cheaper than going to a doctor’s office.

Here, Medical News Today discusses five at-home tests. Those that require people to send off samples use certified labs to process these and healthcare professionals to review results.

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.

Results turnaroundAccepts FSA or HSAPrice
Everlywell5–7 daysyes$49
LetsGetChecked2–5 daysyes$89
LabCorp OnDemand3–4 daysyes$89
Pinnacle Biolabswithin minutesno information available$24.99
Exact Sciences2 weeksno information availableno information available

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 request a test through a doctor or attend a telemedicine appointment.
  • Price: At-home test prices vary but are often between $24 and $90.

All FIT tests should contain clear instructions and a collection pot for the sample.

If a company offers lab testing, they will likely include a prepaid envelope to send the sample through the post.

Some companies will include instructional videos on how to take a sample on their website.

A healthcare professional or the company a person purchases a test from should always provide instructions on performing a FIT test.

Generally, people will need to place a container or some toilet paper into the toilet bowl before having a bowel movement. Most collection kits will come with an applicator, which a person inserts into the stool to collect the sample without handling feces.

People then place the stool into the collection tube and follow the instructions for posting the sample.

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 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.

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.

Various 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.