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FIT to be tried: New inexpensive at-home test available to detect colon cancer

Wed, March 15, 2017

For those who are concerned about their gastrointestinal health but just can’t stomach the thought of a colonoscopy, there’s hope: An inexpensive, non-invasive colon cancer test is now available that you can do at home without the unpleasantness that comes with preparing for a colonoscopy.

It’s called a FIT test, or fecal immunochemical blood test, a newer and more accurate way of testing for blood in the stool that is better at detecting cancer than the older guaiac fecal occult blood test, or gFOBT. The gFOBT requires samples from three different bowel movements and requires a person to adhere to several diet restrictions before the test.

Dr. Srinivas Bramhadevi of West Georgia Family Practice is very passionate about helping his patients get tested early for colon cancer. Screening can help find cancer early, when it’s small, hasn’t spread, and is easier to treat.

When colorectal cancer is found at an early stage before it has spread, the five-year relative survival rate is about 90 percent, according to statistics from the American Cancer Society. But only about four out of 10 colorectal cancers are found at this early stage. When cancer has spread outside the colon or rectum, survival rates are lower.

Dr. Bram hopes to change that statistic in his office, where he has been working with WellStar West Georgia Medical Center’s Oncology Services and Laboratory Services teams to track the FIT testing outcomes of his patients.

Dr. Bram’s office began piloting the FIT test for West Georgia Physicians in November 2016. He encouraged those over the age of 50 who had not been previously screened to consider FIT testing if they felt they could not handle having a colonoscopy.

About 70 patients tried the new test, and 10 had positive results. Every patient with a positive result had follow-up testing with a gastroenterologist. A mass was discovered in one patient during a colonoscopy, and it was surgically removed.

As a result of Dr. Bram’s pilot program for the West Georgia Physicians group, additional WGP primary care offices are now offering the test, including West Georgia Primary Care – Hogansville, West Georgia Physicians West Point Clinic, West Georgia Physicians in Greenville and Pine Mountain, and West Georgia Physicians Internal Medicine.

Medicare and most insurance companies will cover the cost of FIT testing, depending on a person’s age. The self-pay cost for patients screened through offices affiliated with West Georgia Physicians is $22.50.

For FIT testing to be successful, a patient needs to repeat it annually and be committed to having a follow-up visit if he or she tests positive.

A colonoscopy is still the gold standard for detecting colon cancer and other abnormalities. The current guidelines for people of average risk is to have a colonoscopy every 10 years, starting at age 50 to about age 75. It also is recommended that those with a family history of colon cancer be screened earlier than 50.

Dr. Bram’s colleagues at West Georgia Physicians Gastroenterology, Dr. Robert Coggins and Dr. Chad Sisk, perform about 1,400 colonoscopies a year.

“It really can be a challenge to have to drink the large amount of liquid to prepare for a colonoscopy, and some people can tolerate it more than others,” Dr. Sisk said. “But if someone tells us, ‘I really don’t think I can do this,’ we do have a few other options available we can discuss with them.”

Those options, of course, include FIT testing. There also is now a newer bowel prep medicine that is mixed with less liquid so a colonoscopy can be performed.

Colon cancer is the third most common cancer in the United States, killing about 50,000 people a year.

Dr. Sisk said you are at the highest risk of developing colorectal cancer if you have a family history. Other risk factors are excessive alcohol use; a high-fat, low-fiber diet; and smoking.