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A colonoscopy is about as exciting as a trip to the dentist or DMV — OK, maybe even less exciting.

But for those at average risk of colon cancer, there’s an easier, less invasive way to screen for the disease from home. Fecal immunochemical tests (FITs) are a good option for those:

  • Lower gastrointestinal symptoms can come from hemorrhoids.
  • without a history of colon cancer or an inflammatory bowel disease (IBD)
  • Without siblings or parents who have been diagnosed with colon cancer before 60.
  • There are no more than two relatives diagnosed at any age.

We have picked the best FIT options and you can read more about them.

What is a FIT?

FIT is one type of colon cancer screening test that uses a stool (feces) sample. FIT screening checks for blood (hemoglobin) in your stool.

Unusual growths in the colon can cause blood in your stool to be invisible.

When a doctor orders a test, many people self- take it at home. This makes kits a good idea. It is convenient, less intrusive and more cost effective to have a FIT. They can be used for screening.

According to the American Cancer Society, FIT screening must be done yearly to appropriately check colon health.

We looked for tests that were valid.

  • You can easily take it home.
  • The FDA approves these drugs.
  • The College of American Pathologists (CAP) accredited and Clinical Laboratory Improvement Amendments (CLIA) certified laboratories are used by the companies.
  • Good customer service and support are what are made by companies.

Pricing guide

  • $ = under $50
  • $$ = $50–$100
  • $$$ = over $100

Best FIT with subscription option

Everlywell

  • Price: $

Everlywell offers a range of at-home health tests, including a FIT kit.

The test is free and Everlywell offers other services, like help with understanding results, the ability to chat with one of their physicians about test results, and other resources for colon cancer.

The kit requires you to handle stool to send it to a lab. The brush in your kit can be used to do this. You need to brush your stool for about 5 seconds before the brush is put on the test card. You will do the process again using a second brush.

The labs that Everlywell works with must meet high standards to get both state and federal certifications. These labs must submit themselves to regular inspections.

Everlywell has a membership program for $24.99 per month that offers access to a qualifying test every month. So, if you’d like to perform other health checks from home, like an HIV test or cholesterol test, Everlywell makes that easy.

Everlywell accepts health savings account and flexible spending account cards. They offer free shipping for both receiving and sending a sample.

Pros

  • If there is a positive result, Everlywell will offer physician assistance.
  • Users can access more information on colon cancer.
  • You can download and share your results with your doctor.
  • The membership program gives access to other health tests.

Cons

  • The cost is higher compared to other tests.
  • You need to handle stool to send the sample.

Best FIT with fast lab results

LetsGetChecked

  • Price: $$

LetsGetChecked offers a slew of at-home health tests — 34 different tests, to be exact.

You have to collect your stool sample for lab testing. You will get the tube after your bowel movement. You will dip the end of the sample stick into your stool.

After you put the stick back into the tube, you need to secure the cap and place the tube in the bag and box to send it to the lab. The sample should be sent to the lab the same day it is taken.

If your test is positive, LetsGetChecked can offer you a referral to a gastroenterologist or encourage you to visit your primary care physician for further testing.

You can get your results in 2 to 5 days with this brand.

This company accepts both cards.

Pros

  • Nurse assistance is available to discuss positive results.
  • You can download and share your results with your doctor.
  • Kits are packaged in a way that is private.
  • The results are available in a few days.

Cons

  • The cost is higher compared to other tests.
  • You need to handle stool to send the sample.
  • There are restrictions on sample returns.

Best FIT with good lab reputation

Pixel by Labcorp

  • Price: $$

Labcorp has been around for a long time. The network of laboratories handles about 3 million patient samples a week.

You can register your kit online using the website. You need to return your sample to FedEx the same day you take it.

“The website doesn’t say much about how your sample is collected, but it does say that you will be given instructions, a wand and paper to capture.”

A nice feature is that by purchasing the FIT, you have access to physician services from PWNHealth. You can expect the company to contact you if your test comes back positive. Since PWNHealth does receive test results, this could be considered a drawback for those who want results to remain private.

Pros

  • You can download and share your results with your doctor.
  • Labcorp has access to an independent physician group.
  • The company has a network of labs.

Cons

  • The cost is higher compared to other tests.
  • You need to handle stool to send the sample.

Best FIT to purchase in person

Pinnacle Biolabs

  • Price: $

The colon cancer screening test from Pinnacle Biolabs has been the top selling test in the United States for 6 years.

You will use a tube with a wand to collect your stool sample. You will put your stool back into the tube after you gather it with the wand. You will add three drops of the solution to the test cassette. The test window will give you your results in a few minutes.

Two lines show a positive test result, which means blood is in the stool. A negative result is indicated by one line.

You can buy it online or at a major store. This test is free to use.

Pros

  • It’s FDA cleared for over-the-counter use.
  • It is affordable compared to similar tests.
  • It is easy to find in stores.
  • The test is done at home.
  • Within minutes, results are presented.

Cons

  • You need to hold the stool.
  • “It doesn’t come with online support”

Best FIT DNA test

Cologuard

  • Price: $$$

This is a test to screen for genetic diseases.

The website says that your colon is emptied every day. Cells are altered and shed during this routine. These cells are collected in your stool during the movement of your colon. The cells that are identified by the FIT DNA test are precancer and cancer.

This makes Cologuard unique compared with other tests on this list, since it looks for the presence of DNA markers as well as blood (hemoglobin) in the stool. This makes it a more sensitive test, and the only FIT-type test on the list able to detect nonbleeding polyps.

One thing to keep in mind is that the results are reported as positive or negative, without differentiating which part of the test returned a positive result. It is important to follow up with a health professional.

Cologuard is available to people between the ages of 50 and 75. The maximum price for this test is $649.

This test is approved by the FDA.

Pros

  • It is FDA-approved.
  • It can detect both cancer and precancer.
  • It is covered by Medicare and many insurance companies.

Cons

  • It is only available by prescription.
  • You need to handle stool to send the sample.

Best FIT for easy sample collection

QuestDirect

  • Price: $$

“This FIT is a colorectal cancer screening kit that is offered by QuestDirect. They promise that you won’t have to touch the stool, since you will only collect some of the water next to it with a long-handle brush. The company calls it a water sample.”

The surface of the stool should release blood into the water, as explained by QuestDirect. You can apply the water on the brush to the card from the test kit.

“This test is more expensive than others. This company does not accept insurance, but it does not require a doctor’s visit.”

It may take 1 week to receive results, but they can be found in as little as 3 to 5 days. You can share results with your healthcare professional, friends, and family through this portal.

Pros

  • “No doctor’s visit is required.”
  • If blood is detected, you can speak with a healthcare professional.
  • The portal allows for easy sharing of results.

Cons

  • Insurance is not accepted by QuestDirect.
  • The test is more expensive than other options.
  • Results take up to a week, which is longer than other tests.
  • In Alaska, Arizona, and Hawaii, orders are not allowed.

FIT test Price FDA approval Results turnaround Physician consultation Accepts insurance or HSA/FSA Features
Everlywell $ no 5 days contacted only with positive test result HSA/FSA only membership offers access to other tests monthly
LetsGetChecked $$ yes 2–5 days nursing team available HSA/FSA only kit arrives unmarked for privacy
Pixel by Labcorp $$ no not listed contacted by PWNHealth for certain test results HSA/FSA only well established network of labs
Pinnacle Biolabs $ FDA-cleared for OTC use 4–7 minutes no neither fully done at home, results in minutes
Cologuard $$$ yes 2 weeks 5–20 minute session with a PWNHealth provider available •accepts insurance
may accept HSA/FSA
also tests DNA, detects both precancer and cancer
QuestDirect $$ no 1 week for online results, 3 weeks for results in the mail opportunity to speak with a licensed healthcare professional if blood is detected may accept HSA/FSA free patient portal offers easy results sharing

Before ordering your test, you should consider a few factors.

“If you have insurance, you should decide if you want to use a test that accepts it. If you don’t mind paying out of pocket, you may be able to consider more options.”

Next, consider whether you are comfortable handling stool directly. The sample collection process for some tests is more involved than others.

How long does a company take to give you results? Results can be obtained in a few days or a couple of weeks. You can get a kit from the same company that gives you results in minutes at home.

A fit kit is a good choice for anyone.

  • “Doesn’t have a history of colon cancer or IBD.”
  • “Doesn’t have siblings or parents who were diagnosed with colon cancer before 60.”
  • There are two or fewer relatives that are diagnosed.

Otherwise, it’s best to contact your doctor for a colonoscopy or sigmoidoscopy instead.

Colon cancer screening is the gold standard, regardless of risk factors.

Other than being ready for a bowel movement, there’s no prep work required.

It’s best not to take stool tests during your menstrual period or while actively bleeding from hemorrhoids.

Be careful with your instructions, they are similar but be careful.

Some kits screen at home without sending a sample to the lab. Some kits require you to send a sample for the results. Make sure you know what you need before buying.

If you have to send a sample for testing, you should write down the information you need on your kit, including your name, date, and so on.

After you have completed the collection method, you will package the materials in the provided box and send them for testing.

If your test result is negative, you can simply do another test in a year or so.

If your test result is positive, there is blood in your stool. Schedule an appointment with your doctor to look into it.

Although they are convenient for home screening, the FIT tests are not a substitute for having a doctor see you and get a colonoscopy. This is true for people who are at high risk of colon cancer.

If you have, you might be at a higher risk.

  • A history of colon cancer or IBD.
  • A family has a history of colon cancer before 60.
  • Two or more relatives have had colon cancer.

There are a few other lifestyle-related risk factors for colon cancer to consider as well, like alcohol intake, physical activity levels, and smoking.

The Centers for Disease Control and Prevention (CDC) recommends that people between ages 45 and 75 get checked regularly for colon cancer.

According to a 2021 review, only 67 percent of patients in the United States are up to date with their colorectal cancer screening. The hope is that FIT may help bridge the gap in regular screening for those at average risk who may have less access to a colonoscopy or who simply prefer a less invasive and more convenient screening option.

The main differences between colonoscopies and FITs are listed here.

Colonoscopies require more prep work

Colonoscopies are the gold standard for colon cancer testing, but they are also considered a hassle for a few reasons. They usually need prep work, diet restrictions, and time off from work or school. They can be uncomfortable, even though they are not painful.

FITs must be done more frequently than colonoscopies

Although 2019 research shows FIT is nearly as effective as colonoscopies, one drawback is that you must do it yearly to detect colorectal cancer. This is much more frequent than the even more accurate, though uncomfortable, colonoscopies.

Colonoscopies are more accurate and a better choice if you’re at high risk

Those at high risk of colon cancer — including those with a family history, prior colon cancer diagnoses, or history of IBD, as well as other known risk factors — should get a colonoscopy.

Colonoscopies, like most procedures, have a few risks. A 2011 report from the American Society for Gastrointestinal Endoscopy states that there are fewer than 3 serious complications for every 1,000 procedures performed on people with an average risk of colorectal cancer, and a follow-up review from 2019 found that the level of risk had stayed the same over time.

Is an at-home FIT accurate?

While FITs are almost as useful as colonoscopies, these tests are still susceptible to user error. Research from 2018 suggests there’s also a risk of false-positive and false-negative results.

Colonoscopies are considered to be the gold standard. They may be the best way to screen for colon cancer, especially for people who are at high risk.

Is a FIT test as good as a colonoscopy?

A 2019 review shows FITs are almost as effective as colonoscopies, but colonoscopies are considered the gold standard in screening. They’re even more accurate, and they’re necessary for those with a high risk of colon cancer.

Is a FIT test the same as Cologuard?

Cologuard is a particular test, while a FIT test is a fecal immunochemical test. Cologuard is different from other FIT options because it can test for both precancer and cancer. Most FITs only test for the presence of blood.

When should you take an at-home colon cancer test?

If you are at average risk of colon cancer, and you prefer a less intrusive screening option, a FIT is a good option.

How can colon cancer be detected without a colonoscopy?

Colon growths and polyps in the large intestine that can become cancerous may cause bleeding. A FIT can detect unseen blood in the stool. Blood in the stool may signal the presence of these growths or polyps.

How does the FIT compare with the gFOBT?

The guaiac-based fecal occult blood test is a test that can detect blood in the stool.

Experts in a 2018 review considered FIT to be the better testing option for a couple of reasons. Not only is the FIT more effective at detecting blood in the stool, but it also doesn’t require any prep before testing.

Does insurance cover at-home FIT kits?

“Insurance may cover some kits, but it is not a guarantee. It is a good idea to call your insurance provider to find out the cost. Some affordable options are available if your insurance doesn’t cover the cost of FIT.”

Colon cancer can be detected with a test for blood in the stool.

There are a range of styles and prices. Some require you to send a sample to a lab for testing, while others allow you to screen at home.

The FIT is a good option for people at average risk of colon cancer who would like to avoid the hassle of a doctor visit and prep time.

People at high risk of colon cancer should still have a colonoscopy.

The test will need to be performed every year instead of every 10 years for those who choose the FIT.


Breanna is a writer in Cleveland. She holds a masters degree in media and journalism.