Home Blog Resources FIT Beats All Other Screening for Effectiveness and Cost FIT Beats All Other Screening for Effectiveness and Cost December 2, 2010 • By Fight CRC Resources Share on Facebook Share on LinkedIn Share on Twitter Copy this URL Share via Email In a computer simulation, FIT -- fecal immunochemical testing -- done every year saved more lives and cost the least of any colorectal cancer screening method, including colonoscopy. The computer model looked at 100,000 average risk people and compared screening methods results for number of colorectal cancer casesnumber of colorectal cancer deathscost of screening and treating colorectal cancer for each screened person Compared to not screening at all, annual FIT could save 3 out of 4 deaths from colorectal cancer. For every 100,000 people between 50 and 75, nearly 3,500 people wouldn't get colorectal cancer, and over 1,300 wouldn't die. Not only did FIT screening save the most lives, but it was also the most cost-effective. It saved about $70 (Canadian) in screening and cancer treatment expenses for each person screened, better than any other method. FIT vs Colonoscopy Steven Heitman, of the University of Calgary in Alberta and his team found If no one was screened at all, there would be 4,857 cases of colon or rectal cancer and 1,782 deaths over the lifetime of every 100,000 people in North America.Annual testing with FIT reduced cases of colorectal cancer to 1,393 and deaths to 457.Colonoscopy done every ten years, with follow-up exams every 3 to 5 years when polyps were found, would reduce cases to 1,825 and deaths to 624. While FIT was more effective than colonoscopy, it needed to be done every year, while colonoscopy screening is recommended every ten years. The researchers wrote, Although it may seem counterintuitive that screening with FIT could be even more effective than colonoscopy, this is due to the more frequent screening interval with FIT. The computer assumed that patients would adhere to a program of annual testing with follow-up colonoscopy for positive testing 63 percent of the time. When adherence fell below 40 percent, colonoscopy became a better option. Healthcare Costs of Screening and Cancer Treatment In considering health care costs, the research team included the cost of screening itself, follow-up colonoscopy when required, treating bleeding or perforation complications of colonoscopy or CT colonography, and the cost of recommended surgery and chemotherapy for each stage of cancer. They also included expenses for time and travel for patients and caregivers. All costs were reported in 2008 Canadian dollars. All methods included in the model were considered to be done at the recommended intervals, with appropriate follow-up. . Per person screened, the cost of screening and recommended cancer treatment, including biologics for stage IV cancer: FIT --$1,833No screening -- $1,901High sensitivity FOBT -- $2,084Colonoscopy -- $2,100Low sensitivity FOBT -- $2,192Flexible sigmoidoscopy -- $2,263CT colonography-- $2,409Fecal DNA test (2nd standard) -- $2,491Fecal DNA (first standard) -- $2,720 FIT vs Other Screening Methods A fecal immunochemical test with mid-level sensitivity was more effective than any other screening method overall. A higher sensitivity FIT reduced cancers and cancer deaths, but cost more. A low sensitivity test, with only one sample, was less effective overall -- costing more and reducing fewer cases and deaths. Method CRC Cases Deaths No Screening 4,857 1,782 FIT-high 1,290 432 FIT -mid 1,383 457 CT-colonography 1,796 593 Colonoscopy 1,825 648 Flexible Sig 2,634 918 FIT-low 2,634 918 Fecal DNA (2nd) 3,129 1,143 FOBT -- low 3,457 1,250 FOBT -- high 3,890 1,368 Fecal DNA (1st) 4,131 1,530 In conclusion, Steven J. Heitman and colleagues at the University of Calgary in Alberta wrote, CRC screening with FIT reduces the risk of CRC and CRC-related deaths and lowers health care costs in comparison to no screening and to other existing screening strategies. Health policy decision-makers should consider prioritizing funding for CRC screening using FIT. Although FIT proved the best at preventing new cancers and cancer deaths, all the screening methods studied were better than no screening at all. Colorectal cancer screening saves lives! The American Cancer Society has an excellent review of the current screening guidelines with detailed descriptions of each of the screening methods that were modeled. SOURCE: Heitman et al., PLoS Medicine, November 23, 2010. An Open Access article from the Public Library of Medicine. What Does This Mean for Patients? This study offers more information about effective ways of screening for colorectal cancer. Although you may have considered colonoscopy the "gold standard", this research demonstrates that for a large group of people, annual FIT testing actually prevents more cases of cancer and saves more lives. If the risks of colonoscopy screening concern you, choosing FIT might be a choice for you. If you do you need to be sure: You are willing to do the test every year.You realize that a positive test needs colonoscopy follow-up and you are willing to do that.Your doctor explains the sensitivity of the different FIT tests and you are given one that has mid to high level sensitivity.You get clear instructions for completing the test at home and mailing it back.You are an average risk person with no family or personal risks for colorectal cancer. FIT might also be an affordable choice for people without insurance -- although if positive, colonoscopy is necessary. FIT is a different fecal test than the more commonly used FOBT -- fecal occult blood test. In the computer model, FOBT screening prevented the fewest cancers and saved the fewest lives except for the earlier version of fecal DNA testing. Be sure that the test you are getting is a fecal immunochemical test. 6 thoughts on “FIT Beats All Other Screening for Effectiveness and Cost” Thank you for this thorough post on FIT test, many would have questions whether it is reliable or not. I know this website gives quality based articles and extra material, is there any other website which presents these kinds of data in quality? Thanks for noticing that we work hard to provide info from reliable sources. For medical and research news, we scan medical journals, NCI, NCCN, ASCO and other medical professional sites. American Cancer Society has good quality info. We avoid press releases, personal testimonials, etc. I am truly happy to glance at this webpage posts which consists of tons of helpful information, thanks for providing such data. Currently FIT is only available to physicians who can purchase the test kits and give them to patients. Your primary care doctor should be able to obtain the kits through sales representatives from the companies who make them. Quest Diagnostics sells the Insure FIT. Beckman Coulter sells Hemoccult ICT. Depending on the size and number of your husband’s polyps, he should be getting colonoscopies every 3 or 5 years. FIT might not be a replacement for those exams, but might be used in the years between them. Talk to the doctor about that. However, there is no direct evidence that FIT in the interval between colonoscopies reduces colorectal cancer. Where can we purchase the FIT screening kit, or can we be part of a trial. My husband has polyps and would like to find the test, but we can’t find information from our physician. Thanks for any information you can provide. Comments are closed.