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Good alternative to colonoscopy
- Studies show that, for someone of average risk, the FIT test is a good alternative to colonoscopy. There is also evidence that people unwilling to undergo a colonoscopy will complete a FIT test.
www.uclahealth.org/news/article/fit-test-good-alternative-for-those-who-wont-get-colonoscopyFIT test good alternative for those who won't get colonoscopy
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- Overview
- What is colonoscopy?
- Fecal immunochemical testing
- Fecal occult blood testing
- Stool DNA
- Sigmoidoscopy
- CT colonography
- Double contrast barium enema
- A single-specimen gFOBT
- Choosing alternative screening methods
Colonoscopy is a method of screening for colorectal cancer. Doctors can also use a range of other invasive and noninvasive alternatives for screening.
Alternatives to colonoscopy include sigmoidoscopy, which is a less invasive form of colonoscopy, and noninvasive methods, such as stool sample testing.
According to colorectal cancer guidelines published in BMJ, doctors should help people decide on the best screening method and frequency based on their risk of developing this type of cancer.
Below, we look at the various tests that doctors use to check for colorectal cancer. We also outline the official recommendations for screenings.
Medical professionals use colonoscopy to check the large intestine for abnormalities, often when screening for colorectal cancer.
During the procedure, a healthcare professional inserts a long tube, called a colonoscope, into the rectum and along the length of the colon. This tool creates images that help identify colon polyps, and it can also remove them using a small wire loop attached to the tube.
Colonoscopy can be costly, cause uncomfortable side effects, and require substantial preparation and sedation.
Health experts once considered colonoscopy to be the best screening tool for colorectal cancer. More recent guidelines acknowledge that other methods can be just as effective, depending on a person’s level of risk and other factors.
Fecal immunochemical testing (FIT) involves analyzing stool samples. FIT is a popular screening choice in many areas of the world, and the Food and Drug Administration (FDA) approves its use.
FIT uses antibodies to detect traces of blood in the sample, which indicates bleeding in the gastrointestinal (GI) tract.
To help avoid inaccurate results, a person should let a doctor know if they have hemorrhoids or anal fissures or are menstruating before giving the stool sample.
For this test, the person collects a stool sample at home and brings it to the doctor. Most insurance companies cover FIT, and it is low in cost.
A person usually needs to repeat FIT every 1–2 years, depending on the doctor’s recommendations.
If FIT results suggest bleeding in the GI tract, the doctor may recommend colonoscopy for further diagnosis.
A fecal occult blood test involves analyzing a stool sample and is an alternative to FIT. The ACP particularly recommends high-sensitivity guaiac-based fecal occult blood tests (gFOBT).
For gFOBT to screen effectively, a person should undergo it every 2 years.
This test checks for blood and specific DNA in a stool sample, which could indicate the presence of colon cancer. A doctor may use a stool DNA test alongside FIT.
If the test detects any abnormality, a person may need to undergo colonoscopy.
A sigmoidoscopy is similar to a colonoscopy, but it checks a smaller portion of the large intestine.
Sigmoidoscopy is an invasive procedure that requires preparation, including fasting and taking pills to induce diarrhea or having an enema to clear the colon.
This method carries fewer risks than colonoscopy, and it is often less expensive. However, it does not evaluate the whole of the colon.
A doctor can detail the benefits and risks of colonoscopy and sigmoidoscopy for each individual.
CT colonography involves taking detailed images of the colon.
The procedure does not require sedation. However, as with colonoscopy, a person will need to use medications or an enema to clear the colon beforehand.
During the procedure, a healthcare professional will inflate the colon with air to provide a better view.
If the test detects an abnormality, a colonoscopy is necessary.
A double contrast barium enema is a type of X-ray that helps a doctor examine the colon. The barium helps create clear images of the colon.
Doctors rarely use this method, because — unlike colonoscopy — it does not detect small polyps and tumors. However, it is an option for people at risk of colonoscopy complications.
Some doctors collect a single stool sample during a routine rectal examination and analyze it with gFOBT.
However, research has not shown this to be an effective method of screening for colorectal cancer.
Guidelines from the American College of Physicians (ACP), published in 2019, recommend that adults with an average risk of colorectal cancer undergo screenings between the ages of 50 and 75 years.
According to the guidelines, a person and a doctor should decide on the method of screening based on a discussion of:
•the benefits of each technique
•possible complications
•costs
•availability
Jun 15, 2022 · FIT testing is noninvasive, convenient, and cost-effective, making it an acceptable alternative to a colonoscopy for many people. If a stool test is positive, a colonoscopy is needed to evaluate the reason for the positive test.
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Jun 21, 2023 · As reviewed already in this article, as a 1-time test FIT is limited in its ability to detect adenomas and serrated neoplasia even less so. Unlike FIT, colonoscopy provides 1-step CRC prevention, diagnosis of early cancer, and long-term protection to those with negative examinations.
Oct 28, 2022 · Studies show that, for someone of average risk, the FIT test is a good alternative to colonoscopy. There is also evidence that people unwilling to undergo a colonoscopy will complete a FIT test. Considering that only half of adults stick to the suggested colon cancer screening schedule, and 30% skip screening altogether, the FIT option is ...
Apr 27, 2023 · Fecal immunochemical test (FIT): This is an inexpensive, at-home, stool-based test that looks for proteins found in the blood. Blood in the stool could be a sign of colon cancer, and a positive FIT test would signal that you need to get a colonoscopy.
May 1, 2024 · Doing a FIT once a year is a good option for those at average risk of colon cancer who don’t want to undergo a colonoscopy, have less access to colonoscopies, or prefer a less invasive screening...
