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Colorectal cancer is one of the most common forms of cancer in the world (in 3rd place among all types of cancer, including in second place in women after breast cancer, in third place in men after prostate cancer and lung cancer), and the availability of new case histories is more than 1 billion a year and 500,000 deaths annually. In the initial stages, bowel cancer does not manifest itself. Targeted research on oncology often begins too late, when surgery or chemotherapy is required.
It is important to know that any cancer is curable if detected early. Early diagnosis can reduce the dynamics and percentage of people’s mortality, increase survival after the detection of the disease, reduce the time and money spent by the state, employers, and the population on treatment, rehabilitation, and monitoring of relapses. Starting from the age of 40, the use of immunochemical rapid oncotests and / or colonoscopy is recommended. These procedures reduce colorectal cancer mortality by 50% and morbidity by 20%.
Colorectal cancer is one of the more insidious cancers – it can take years to develop without symptoms. The only way to detect it in time and thus save your life is through checkups. One of them is a test that can be easily done at home – the so-called FIT test. Scientists have announced that it is almost as effective at detecting lesions as colonoscopy. Moreover, for some people, it may be an acceptable alternative to this test. The test is also available in Poland.
In the prevention of colorectal cancer, the basic and most important examination is colonoscopy, i.e. examination of the entire large intestine. This is the only way to detect all precancerous lesions – i.e. polyps (so-called adenomas). A colonoscopy is recommended for anyone over 50 years of age.
The journal “Annals of Internal Medicine” recently published analyzes of studies comparing the effectiveness of colonoscopy and the above-mentioned FIT test. They were conducted by scientists from the Indiana University School of Medicine and the Regenstrief Institute in Indianapolis. As it turned out, the sensitivity of the home test (i.e. its ability to detect the disease) reached 75-80 percent, while the colonoscopy itself – 95 percent.
According to the lead author of the study, gastroenterologist Dr. Thomas Imperiale, the FIT test may be an acceptable alternative to colonoscopy, including in people who do not have inflammation of the gut or colon polyps and in a family where there has been no history of cancer.
What exactly is the FIT test? It is a test for the detection of occult (i.e. invisible to the naked eye) blood in the stool, which you can do yourself at home. It is worth noting that one of the more common symptoms of colorectal cancer is blood on or in the stools; in over 70 percent In patients, bleeding is latent.
The test is painless and the test is free. You can get it by taking part in the campaign “Examine the gut” organized by the Regional Oncology Center of the hospital in Łódź. Copernicus. “People aged 50+ and younger, with a problem of colorectal cancer in their immediate family, are invited to take part in the” I have the intestine test “campaign, under which we have to provide free FIT tests for the presence of occult blood in the feces” – we read on share side. There are also detailed instructions on how to perform the test.
It is worth remembering that while for some people the FIT test may be helpful in the prevention of colon cancer, colonoscopy is still the most sensitive test (if it does not show disturbing changes, it is recommended to repeat it in 10 years; the FIT test should be repeated every year) . A positive FIT test result should always be consulted with your doctor!
What is a home colon cancer test?
A home colon cancer test is a stool test that you perform in the privacy of your home and send to a lab for testing. If the home test is positive, you will need to see your doctor for a colonoscopy.
There are various types of home tests, including:
- Guaiac-based fecal occult blood test (gFOBT) – This test uses the chemical guaiac to detect blood in the stool. You must take this test once a year. You can get it from your health care provider or buy it without a prescription. In gFOBT, you collect stool samples from three bowel movements, which are tested for occult blood. Occult blood means that the blood is not visible to the naked eye. However, gFOBT cannot determine if blood is coming from the colon, rectum, or other parts of the digestive tract, such as the stomach. Avoiding red meat for three days, avoiding more than 250 milligrams of vitamin C per day for three to seven days, and avoiding non-steroidal anti-inflammatory drugs for seven days before undergoing gFOBT. According to the Colorectal Cancer Alliance, gFOBT also requires multiple tests and has a high false positive rate.
- Fecal Immunochemical Test (FIT) – FIT also needs to be done once a year. In this test, antibodies are used to detect blood in the stool. Unlike gFOBT, drugs and food do not interfere with FIT. As a result, FIT tends to produce more accurate results, which reduces the number of retests. You can take this test at your healthcare facility.
- Cologuard Test KitFIT-DNA test – FIT-DNA is also called a stool DNA test. This test combines FIT with a test that checks for altered DNA in the stool. This test can be taken every three years. Cologuard is an example of a FIT-DNA test that is generally 92% accurate in detecting colon cancer. The FIT-DNA test is only available with a doctor’s prescription.
Benefits of home colon cancer tests
“Some patients are reluctant to start a colonoscopy due to preparation or cost,” says Dr. Sujata Nallapareddy, medical oncologist and hematologist at Rocky Mountain Cancer Centers (RMCC). “Also, sometimes their insurance may not allow them to start a colonoscopy.” Previously, the recommended age for screening was 50 years. But now the recommended age is 45 years. Not all insurance companies have accepted this.”
Home tests are also non-invasive. Most home tests require a stool sample to be collected and sent to a lab without preparation. gFOBT, which requires you to follow a specific diet and avoid certain medications for three to seven days before the test, is the only home test that requires you to change your diet beforehand.
Most insurance plans cover home colon cancer tests. However, you should check with your insurer to see if your insurance plan covers them.
“Home tests may be useful in some situations as we see more cases of colorectal cancer in young people,” said Dr. Nallapareddy. “Home tests can help us get started with the screening process, but we shouldn’t rely on them completely as home tests have some drawbacks.”
Disadvantages of home tests
Colon cancer home tests will never be 100% accurate and, as a result, may give you false positive or negative results.
“There is a 10-15% chance of false positives,” says Dr. Nallapareddy. “If you have a positive test, then you need to make sure that a colonoscopy is done after it. If you just do a test and it comes out positive, or if you don’t do any further follow-up on that test, then you shouldn’t do it.”
Home tests cannot check for colon polyps, which may be cancerous, so you may get a false negative result.
“Sometimes you may have symptoms and these tests are negative,” says Dr. Nallapareddy. “If you have symptoms, you can start with a home test, but you will need additional follow-up.”
Another disadvantage of home tests is the frequency of screening. The gFOBT and FIT tests should be performed annually, and the FIT-DNA test should be done every three years. Meanwhile, a colonoscopy is needed once every 10 years for people with an average risk.
Signs and symptoms of colorectal cancer
Early stages of colorectal cancer may not cause many signs or symptoms. However, if you experience any of these symptoms, don’t ignore them:
- A person clutches their stomach in painPain or ache in the abdomen that does not go away
- Bleeding from the rectum, which may look like bright red blood
- Blood in the stool, which can make the stool dark or black
- Changes in bowel habits or movements, such as narrowing of the stool
- convulsions
- Diarrhea or constipation
- Fatigue
- Constant feeling of fullness in the intestines
- Unexplained weight loss
- Weakness
Colorectal cancer can spread to the liver, which can cause the liver to become enlarged or the skin or eyes to turn yellow, a condition called jaundice. If colorectal cancer spreads to the lungs, it can cause difficulty in breathing.
If you have signs or symptoms of colorectal cancer but your home test is negative, see your doctor as you may need a colonoscopy.
Risk Factors for Colorectal Cancer
There are certain risks of developing colorectal cancer that you cannot control. These risks include your age, a family history of colorectal cancer, certain genetic diseases, or inflammatory bowel disease.
Some risks are lifestyle factors that you can control. These include:
- Overweight or obesity
- Alcohol consumption
- A diet low in fruits and vegetables and high in processed meats
- Low physical activity
- Smoking
You can reduce your risk of colorectal cancer by getting enough physical activity, avoiding alcohol and tobacco, and eating a diet high in fiber and low in processed meats. Currently, the American Heart Association recommends 150 minutes of moderate-intensity aerobic activity per week, 75 minutes of vigorous-intensity aerobic activity per week, or a combination of the two.
Recommendations for screening for colorectal cancer
According to the American Cancer Society, if you are in the intermediate risk group, you should start screening for colorectal cancer at age 45 and continue until age 75. After age 75, screening recommendations depend on several factors, such as comorbidities or personal preference.
If you are in a high-risk group, you may need to start screening earlier and more often. You are at increased risk if you:
- have a family history of specific syndromes such as Lynch syndrome or familial adenomatous polyposis
- Have a history of inflammatory bowel disease
- have a family or personal history of colorectal cancer
- You had certain polyps found and removed during a colonoscopy
- Have undergone irradiation of the stomach or pelvis
Before doing a home test, talk to your healthcare provider about which test might be right for you. Whether you get a positive or a negative result, please consult with your healthcare provider.