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A fecal immunochemical test (FIT) is a diagnostic tool that can screen for colorectal cancer. It detects hidden blood in the stool, which indicates bowel characteristics that may be due to colorectal cancer. A positive FIT result will warrant further investigation, and an early diagnosis of cancer generally leads to more effective treatment and a better outlook.

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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. 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. A FIT test uses antibodies to detect 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 their 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 FIT test 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.

Routine screenings

Some people may wish to perform a FIT test as a routine screening because of their age. The Preventive Services Task Force recommends that adults aged 45–75 years undergo screening for colorectal cancer. Other individuals may wish to undergo a FIT test because they are experiencing symptoms that could indicate colorectal cancer. These include:

  • unexplained abdominal pain
  • changes in bowel habits
  • 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 and medical reviewer of this article have not tried these products and do not endorse or reject them. All information is purely research-based and correct at the time of publishing.

Everlywell

Best FIT test with membership discounts

Everlywell states that only those aged 45 years and older are eligible for this screening. A board certified doctor in the person’s state will review all test results, which takes a few days to receive.

One advantage of Everlywell is that its system offers the results through an online dashboard, making them easy for a person to share with their doctor. The cost of the FIT test is around $50, and the company accepts Health Savings Accounts (HSA) payments.

Learn more about the Everlywell brand.

LetsGetChecked

Best FIT test with 24/7 support

LetsGetChecked offers results in 2–5 days. Nurses are available to discuss positive test results with the individual, and a person’s doctor can also download the results.

The test costs around $70 for a single purchase, but someone looking for regular screening tests can save money by subscribing.

Learn more about the LetsGetChecked brand.

Pixel

Best FIT test with positive lab reputation

Pixel describes its testing kit as a “simpler and more affordable” alternative to colonoscopies. As with the tests above, an individual shops and pays online for the Pixel FIT test, which costs around $90.

An independent healthcare professional will review and approve the test request, so a doctor’s visit is unnecessary. However, the service does not indicate how long it takes return test results.

Pinnacle Biolabs

Best FIT test with instant results

Pinnacle Biolabs’ Second Generation FIT offers results in minutes, and it is reportedly the top-selling colon cancer screening test in North America.

The main advantage of this test, which costs around $30, is that an individual performs the whole test at home and does not need to post their sample. They can also see their results within minutes. However, the company does not indicate whether support is available for those who receive positive test results.

QuestDirect

Best FIT test with online results

An individual can order this test online without needing a doctor’s visit, as a physician reviews the order to ensure it is appropriate.

The cost of this test is around $90 plus a $6 doctor’s fee, making it more expensive than some other FIT testing kits.

Cologuard

Best FIT test with DNA testing

This test identifies atypical DNA in stools as well as the presence of blood. This kit is available on prescription from a doctor, but it is also available from one of the company’s telemedicine providers.

The service recommends this screening for individuals over the age of 45, and a person may be able to purchase a kit through their insurer.

In the United States, colorectal cancer is the third most commonly diagnosed cancer. 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 and a colonoscopy, make early diagnosis possible.

Whether an individual undergoes 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 that 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.

FIT tests can detect early signs of colon cancer, but there are other reasons a person may receive a positive result, including colon polyps, pre-cancerous polyps, inflammation, and hemorrhoids. Seeking medical advice is important in ruling out or diagnosing any medical condition. “}}]}

People considering ordering a FIT test to use at home may wonder:

Is a FIT test accurate?

Overall, a 2017 meta-analysis notes that FIT test has a high diagnostic accuracy for colorectal cancer and is a viable screening method.

This conclusion is consistent with a 2017 review, which states that while the FIT test is 95% accurate in detecting colorectal cancer, it has a low sensitivity for detecting colon polyps.

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

The Multi-Society Task Force on Colorectal Cancer recommends that people with an average risk of colorectal cancer begin undergoing screenings from the age of 50 years. However, the ACS recommends starting slightly younger, at the age of 45 years.

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 aged 50 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:

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

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 that 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 the need for a doctor’s visit.