FIT Tests vs. Colonoscopy: What You Need to Know

A recent New York Times article suggests that Americans of average risk of devel oping colon cancer should look toward a fecal immonuchemical test, or FIT test, for their No. 1 choice in colon cancer screenings. But we say, think again.

First, some transparency – FIT tests do offer a more relaxed, easier process for colon cancer screenings such as no prep, no need to skip work or find someone to drive them home. On the surface, this option seems like a no brainer, but what the article fails to detail are the miss rates, false positives and what insurance is willing to cover after a positive test.

FIT tests have a miss rate of 20 percent and can miss most precancerous polyps. FIT tests are also covered by most insurance plans. But, if these tests are positive, then a diagnostic colonoscopy is recommended — the cost of which will go toward the patient’s deductible.  That’s right, if you have a positive result – even a false positive – a colonoscopy is needed and your insurance will most likely not cover it fully. A positive Cologuard test will also produce the same outcome. Additionally, FIT tests require a test every year compared to every 10 years for a colonoscopy.

The article also asserts that gastroenterologists may intentionally not disclose other colon cancer screening methods to patients because of the financial incentive to perform a colonoscopy. This is false. Gastroenterologists recommend colonoscopy because it is the only test that can detect and prevent colon cancer.  At-home tests only detect the disease.

However, the article does stress the importance of getting screened, especially during the COVID-19 pandemic, where GI doctors have seen an 86 percent decrease in colon cancer screenings across the nation.  Only 70 percent of Americans are up to date on screenings, and nearly 40 percent of Americans age 50 or older have not sought their colon cancer screening test whatsoever, according to the American Cancer Society .  The U.S. Preventative Services Task Force and the ACS has recommended lowering the screening age to 45.

If you are age 45 or older and haven’t scheduled a colonoscopy, it’s time to schedule. Colon cancer is the third leading cause of cancer deaths and has a high survival rate if caught early.  Do not wait to schedule this, especially during the pandemic.  We have taken steps to implement all CDC recommendations to keep patients safe.