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Why I Chose FIT—And You Can, Too!

Posted on by DCPC

Photo of Dr. Marcus Plescia

By Marcus Plescia, MD, MPH
Former Director of CDC’s Division of Cancer Prevention and Control

Last year I turned 50. Time to get tested for colorectal (colon) cancer!

If you read our recent Vital Signs report, you know colorectal cancer is the second leading cancer killer of men and women in the United States, after lung cancer. And about 23 million people—that’s 1 in 3 adults—between 50 and 75 have not been tested appropriately.

As a physician, I’ve taken care of people who’ve had colon cancer; it’s serious. As director of CDC’s Division of Cancer Prevention and Control, I lead a national program that promotes colorectal cancer screening. If ever there was a time to step up to the plate, this was it. I told myself, ‘It’s time to practice what you preach!’

The three recommended colorectal cancer screening tests are—

  • high-sensitivity stool tests, including the fecal immunochemical test (FIT);
  • the seldom-done flexible sigmoidoscopy;
  • and the test done most frequently—colonoscopy.

I took a good hard look at each of them.

I understand the science, have good insurance, and can get any test I want. For some time now, I’ve tried to make the argument that colonoscopy is not the only colon cancer screening test option. And if I could do anything to help people understand that there are effective test options, I would.

There is appeal to the argument that with colonoscopy, you can see the inside lining of the colon, so it can be a very thorough checkup, with polyp removal if necessary. But the FIT has advantages, too.

I opted for the FIT because it was a very reasonable option, one I’m comfortable with. It met my needs perfectly. I wanted to lead by example—it’s one thing to say that it’s a very effective colorectal cancer screening test and recommend it to others … another to do it yourself. But that’s not the only reason I chose FIT. I also thought, ‘Boy, this is pretty easy!’ I got the test in the mail, it took about five minutes, nothing unpleasant about it, and I sent it back.

I liked having options, and that I could tailor what test I did to what my preferences were. I liked the idea that it was convenient, and that I didn’t have to take a day off of work. I’m due for my next FIT in April, and I’ll continue to think about and consider the test options every time I’m due for screening. At some point I may get a colonoscopy, though probably not for awhile. I really believe what we say: the best screening test is the one that gets done!

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11 comments on “Why I Chose FIT—And You Can, Too!”

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    I am fortunate enough to work in an office that hands out free guaiac FOBT kits every April. So, naturally, I have taken advantage of this every year, and every year I have gotten negative results. Two and a half years ago, I turned the magic age – 50 – and decided I should get a colonoscopy along with doing the FOBT. Thank God I did. The doctor found three polyps, luckily not cancerous. In a few weeks I will be 53. And although I plan to do the FOBT again this year, I will also be getting my 3-year colonoscopy screening in the fall.

    You don’t need to do further FOBT or FIT testing once you are on the colonoscopy track. A positive FOBT or FIT test will lead to the recommendation for a colonoscopy, but if your colonoscopy showed precancerous polyps, you should continue to have regularly colonoscopies and should not also do FOBT testing, as it is unnecessary. Some people, such as those with a family history of colon cancer at a relatively young age, should have colonoscopies as soon as they are old enough for screening and should not do FIT or FOBT testing at all. FIT testing is a great option for a lot of people but it is not appropriate for everyone. Likewise, people without risk factors for colon cancer or symptoms that warrant a colonoscopy can safely do nothing but annual FIT testing and may never need a colonoscopy.

    Thank you for sharing your story Carolyn. It points out the shortcomings of the guaiac cards. As a simple fact, they are not as sensitive or specific as the FIT test and should not be relied upon for Colorectal Cancer screening. I’m glad you also received your colonoscopy so that your polyps were removed before they could ever turn into Cancer.

    The chance of a polyp becoming cancerous is very small.
    medscape: “Colonic polyps are slow-growing overgrowths of the colonic mucosa that carry a small risk (<1%) of becoming malignant. "

    So NO, it wasn't GREAT to remove those polyps. It was proved to be overkill.

    30-50% of over 50 crowd gets some polyps.
    This scenario is similar ALL OVER YOUR BODY. skin growths and overgrowths…almost all are completely harmless.

    Cadaver studies reveal most people die WITH but not OF tumors on their thyroid.

    Many men die WITH but not OF tumors on prostate.

    At least 1 in 3 diagnosis of breast cancer are simply WRONG.
    ´We estimated that breast cancer was over-diagnosed that is tumors were detected on screening that would never have led to clinical symptoms — in 1.3 million US women in the past 30 years,´ wrote Gilbert Welch, of Dartmout Medical School, and Archie Bleyer, of the Oregon Health and Science University, in their study.

    ´We estimated that in 2008, breast cancer was over-diagnosed in more than 70,000 women; this accounted for 31 per cent of all breast cancer diagnosed,´ they said.

    "Colonic perforation during colonoscopies ranges up to (1 out of 150). Thats pretty high for a serious event and almost NEVER discussed, as it statistically wipes out most of the advertised screening benefit. Particularly for
    an OPTIONAL procedure where 30-50% polyps exist and of each, 1 in 150 it will be cancer! Particularly when your risk of hemorrhaging is 1 in 40!
    When researchers reviewed colon cancer screening data from 1966 to 2001, they discovered the following:

    Perforation occurred in 0.029 percent to 0.72 percent of colonoscopies.
    Heavy bleeding occurred in 0.2 percent to 2.67 percent of colonoscopies.
    Death occurred in about 0.003 percent to 0.03 percent of colonoscopies."

    go for the NON-INVASIVE procedures. The catch is that they provide a false positive, docs will push you for a colonoscopy anyway. crazy eh? non scientific , eh? yes and yes.

    It is a very interesting material but I am a Pharmasist and I can look migrants in Moscow with colorectal disease. May be our people have the same diagnosis too but I looked the patients with problems with treatment after Platinum-Based Chemotherapy in metro with long growth nails in foots before the death. It is cochmar.

    This is a fantastic article. It would be great to get the word out about how far the FIT has come since it’s FDA approval. As a widely studied test, great improvements have been made in the FIT test since its FDA approval.

    Most people, including the CDC, don’t realize that today’s FIT test is the obvious choice for population based screening of colorectal cancer due to cost and life-gained years. Most people don’t realize that the American College of Gastroenterology recommends a colonoscopy every ten years and an annual FIT test. Why? It’s been widely studied and proven that FIT annually plus colonoscopy every ten years detects colorectal cancer two years earlier than colonoscopy alone.

    More importantly, Dr. Plescia begins his article with some statements: He has good insurance, is a man of science who comprehends the different tests on a level the average person does not, and has no economic barriers to an test. It’s our job to get the word out that you don’t need insurance to have a FIT test, and economic barriers are gone too. A Second Generation FIT test is now OTC cleared (for home use – think a pregnancy test that you’d pick up at Walgreens) by the FDA. It’s commercially available for $20.00 from Pinnacle BioLabs and is extremely easy to use.

    Authoritative websites such as the CDC, American Cancer Society, and even the governments Colon Cancer Control Program make no mention of such an option.

    We are talking about 5 minutes, once a year, and done.

    For more information click here:

    I have had 2 colonoscopy’s since turning 50, both times I had heard how awful the prep the night before the procedure tasted, for me, not true. I bought the solution prescribed by my doctor, followed the directions and after all the terrible reviews my friends had shared with me, I found it most exceptable. Next morning, I checked into my local hospital for the colonoscopy. After being attended to by the nurses,my doctor greeted me and we both(me in a johnny coat) walked to the OR,8 minutes later I was back in bed in recovery being served english muffins and tea.. Everything was Ok. Please get this one done, it’s almost boring!

    Very informative post. I enjoyed reading. Cancer is spreding its wings very furiously we need to take proper care of ourselves and need to read posts like this to get aware. Thanks for sharing this with us.

    I did not have any family history of colon cancer and proud to take care of my health through proper diet, exercise and stress management. I had a FoBT test at 48 (negative), a FIT Test at 51 (negative), but soon after learned my sibling had a few pre cancerous polyps removed at 54. So, I decided to be careful and get a colonoscopy 6 months after my neg fit result. Glad I did, I had one polyp discovered that was precancerous biopsy that was safely removed. Next one in 3 years.
    I would opt for FIT tests starting earlier at 45, even if you have to pay, and for sure colonoscopy at 50! I’ve seen first hand colon cancer and it’s not pretty. Get checked

    What is often not mentioned in discussions of colonoscopy preps is that for some of us with very high rates of metabolism the idea of going without food for a day is about the worst possible thing imaginable. Cancer is worse, yes, however if FIT tests rate highly on sensitivity and specificity they become a viable option. While perhaps not as reliable as a colonoscopy, for those of us who feel like we are going to die if we do not eat after three hours a FIT is an alternative worth considering!

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