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Simple At-Home Stool Tests Detect Most Colon Cancers

FIT requires only one stool sample (February 4)

Tests that require patients to collect a single stool sample at home and then send it to a lab for analysis will detect about 79% of colorectal cancers, according to a new meta-analysis published in the Annals of Internal Medicine. The review of 19 studies examining eight different fecal immunochemical tests (FITs) also found that the tests will correctly identify about 94% of patients who do not have cancers of the rectum or colon.

The 19 studies reviewed included between 80 and 27,860 patients, with average ages ranging from 45 to 63 years. All of the studies included patients with no symptoms of colorectal cancer. In 12 of the studies, all of the patients took the FIT and received a colonoscopy. In seven studies, patients had only a colonoscopy to follow-up on a positive FIT. Approximately 2 years later, researchers followed up with patients who had had a negative FIT to determine whether they had been diagnosed with colorectal cancer.

On average, the tests detected 79% of cancers with only one round of testing. The tests were also highly specific: on average, 94% of people who did not have cancer tested negative with a single FIT.

By comparison, studies indicated that another at-home test — the fecal occult blood test (FOBT) — detects only about 13% to 50% of cancers after a single round of testing. FOBT is the predecessor to FIT and requires three stool samples as well as medication and dietary restrictions.

According to the evidence review, no single FIT performed markedly better than another, but the authors caution that only one study compared brands head-to-head. Most of the FITs required the collection of only one stool sample. Surprisingly, the authors found that brands requiring two or three stool samples were no more accurate than those requiring only one sample.

“FIT is simple, can be done at home, and can save lives,” said lead author Jeffrey Lee, MD, MAS. “The American Cancer Society and other professional organizations have recommended FIT as a screening tool for colorectal cancer since 2008, but there are still many people who don’t know about it.”

Sources: Annals of Internal Medicine; February 4, 2014; and Kaiser Permanente; February 3, 2014.

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