For Providers
For Patients 

FIT is a screening option that allows patients to procure samples in the comfort of their homes and at their convenience. When used yearly, FIT has accuracy rates very near those of colonoscopy.

FIT: A New and Improved Fecal Occult Blood Test

• FITs have superior sensitivity and specificity.
• FITs use antibodies specific for human globin and are, unlike the guaiac test, specific for colorectal bleeding and not affected by diet or medications.
• Some FITs can be developed by automated developers and readers. This innovation allows for management of large numbers of tests in a standardized manner with excellent quality assurance.
• There is evidence that FIT use improves patient participation in screening for colorectal cancer by giving patients another choice.
• New technology for FITs allows them to quantify fecal hemoglobin so that sensitivity, specificity, and positivity rates can be adjusted in screening for colorectal neoplasia.

Increase Your Colorectal Cancer Screening Rates

FIT is a great way to increase colorectal cancer screening rates in your practice. Its convenient, easy-to-use nature can help overcome many of these common barriers to screening:

• Time Constraints
• Transportation
• Lack of Insurance
• Unwilling to Complete Colonoscopy Prep Requirements
• Patient Non-Compliance

The Florida Department of Health recommends a yearly FIT for patients who experience one or more of these barriers. Medicare, Medicaid, and many health insurance companies cover this test, making it easily accessible to many patients.

We have materials available to help you reach your patients and inform them of the availability of FIT. For more information about FIT and these available materials, see the section below. Together, we can improve colorectal cancer rates in your practice.

Helpful Resources

• FIT Poster
• FIT Flyer
• FIT Envelope
• FIT Patient Postcard
• Centers for Disease Control and Prevention
• National Cancer Institute
• U.S. Preventive Services Task Force Recommendations (Update in Progress)
• Editorial - Less is More: Not "Going the Distance" and Why
  Russell Harris and Linda S. Kinsinger; Journal of the National Cancer Institute 2011
• The Role of Fecal Occult Blood Testing in Screening for Colorectal Cancer
  James E. Allison; Practical Gastroenterology 2007
  
  Page 22: "In addition, FITs do not react with nonhuman globin or with food such as uncooked fruits and vegetables that may contain peroxidase activity. Dietary restriction is therefore not necessary when screening with these tests. They are also unaffected by medicines such as non-steroidal anti-inflammatory drugs or Vitamin C. All these features may make use of FIT more acceptable to those screened than the GT (guaiac test)."
• Comparison of a Brush-Sampling Fecal Immunochemical Test for Hemoglobin With a Sensitive Guaiac-Based Fecal Occult Blood Test in Detection of Colorectal Neoplasia
• Colon Cancer Screening Guidelines 2005: The Fecal Occult Blood Test Option Has Become a Better FIT
• Fecal Immunochemical Tests (FIT) vs. Office-Based Guaiac Fecal Occult Blood Test (FOBT)
  Alicia Smith, Graeme P. Young, Stephen R. Cole, Peter Bampton; Cancer 2006
  
  Page 2152: "Fecal immunochemical tests (FIT) are an advanced fecal occult blood test (FOBT) technology that reduces barriers to population screening by simplifying the logistics of stool-sampling."
  
  Page 2157: "It [FIT] is a simple, convenient and noninvasive way to draw healthy persons into screening, especially those reticent to undergo any form of screening, including colonoscopy." James E. Allison, MD; Gastroenterology 2005
  
  Page 745: "The fecal immunochemical tests (FIT) address many of the weaknesses of the GT (guaiac test). They have superior sensitivity and specificity."
  
  Page 746: "...and a program strategy of FIT might be able to uncover both the colonoscopy misses and the fast-growing lesions."
  
  Page 747: "If, as it appears, the FIT has better performance characteristics than the GT, which is compelling evidence for recommending its use as the FOBT of choice in colon cancer screening programs." Graeme P. Young; Practical Gastroenterology 2004
  
  Page 46: "The criteria for the ideal FOBT are best met by FIT. Clinical performance is also better with FIT as they have a better sensitivity: specificity ratio."
  
  Page 52: FITs appear well-placed to overcome the shortcomings of gFOBT and fit into this changing face of screening.

FIT is an easy colorectal cancer screening option that doesn't interfere with your active or busy lifestyle. FIT allows you to collect the necessary samples at your convenience from the comfort of your home. Performing a yearly FIT is a highly effective method for detecting and thereby helping to prevent progression of colorectal cancer.

What Is Colorectal Cancer?

Colorectal cancer is a malignant growth that develops inside the large bowel. Most bowel cancers develop from tiny growths called polyps. Not all polyps become cancerous. However, some polyps can become cancerous over time. Cancer can narrow and block your bowel or cause bleeding. In more advanced cases, cancer can spread beyond the bowel to other organs.

Colorectal cancer is the fourth most common cancer in the US, affecting approximately 140,000 new patients every year and causing approximately 50,000 deaths. These numbers are staggering given the fact that most colorectal cancer is preventable and treatable.

How Important is Screening?

In a word: Very. Colorectal cancer, though one of the deadliest forms of cancer, is the most preventable and treatable. But prevention and treatment starts with screening on a regular basis.

If colorectal cancer is detected before it has spread beyond the bowel, the chance of surviving for at least 5 years after diagnosis is 90%. Most people are able to return to their pre-cancer lifestyles.

Early detection offers the best hope of reducing the number of Americans who die each year from colorectal cancer. If you're over 50, don't be embarrassed about your risk factors. Talk to your doctor about colorectal cancer screening today.

Colorectal Cancer Screening Guidelines

Regular screening, beginning at age 50, is the key to preventing colorectal cancer. The U.S. Preventive Services Task Force (USPSTF) recommends screening for colorectal cancer using high-sensitivity fecal occult blood testing, sigmoidoscopy, or colonoscopy beginning at age 50 years and continuing until age 75 years.¹

People at higher risk of developing colorectal cancer should begin screening at a younger age, and may need to be tested more frequently. The decision to be screened after age 75 should be made on an individual basis. If you are older than 75, ask your doctor if you should be screened. For more information, read the current colorectal cancer screening guidelines² from the USPSTF.

Recommended screening tests and intervals are²:

• High-sensitivity fecal occult blood test (FOBT), which includes FIT, checks for hidden blood in three consecutive stool samples, should be done every year.
• Flexible sigmoidoscopy, where physicians use a flexible, lighted tube (sigmoidoscope) to look at the interior walls of the rectum and part of the colon, should be done every five years.
• Colonoscopy, where physicians use a flexible, lighted tube (colonoscope) to look at the interior walls of the rectum and the entire colon, should be done every 10 years. During this procedure, samples of tissue may be collected for closer examination, or polyps may be removed. Colonoscopies can be used as screening tests or as follow-up diagnostic tools when the results of another screening test are positive.

References

1. U.S. Preventive Services Task Force. Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement. AHRQ Publication 08-05124-EF-3, October 2008. Agency for Healthcare Research and Quality, Rockville, MD.
2. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services, 2008: Recommendations of the U.S. Preventive Services Task Force. AHRQ Publication No.08-05122, September 2008. Agency for Healthcare Research and Quality, Rockville, MD.

Why FIT?

Many patients use FIT as an easy way to screen for colorectal cancer and stay informed about their health. Here are several reasons why FIT may be a great option for you:

• It is easy to do.
• There are no special changes to diets or medicines.
• There is no need to change medications.
• There are no liquids to drink.
• You don't have to take a day off work.
• It is done in privacy of your home.

What Can I Do?

If you're over 50, ask your doctor about screening options for colorectal cancer, including the new take-home test called FIT. If you are at high risk for colorectal cancer, you may need to be screened more frequently.

Tell your friends and loved ones about the importance of screening for colorectal cancer. We can lessen colorectal cancer's impact by increasing the number of citizens who are regularly screened for this preventable and treatable disease.

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