If you are being recommended colonoscopy as a regular-risk person on the basis of age, your health system is not serving you well. Compared to colonoscopies, regular FOBT or FIT testing has an insignificant risk of complications (bowel perforations, death etc) and is easily conducted at home without the unpleasant “preparation” required of a scope. If done every 2-3 years they are at least as (and maybe more) effective at detecting cancer compared to a scope.
FIT/FOBT: low-cost, low-barrier, easy and 100% safe test done by the patient themselves at home
Colonoscopy: expensive, resource-intensive, onerous, invasive, time-consuming and while usually safe there are complications up to and including death
Even though an individual colonoscopy is more sensitive than an individual FOBT/FIT, regular use of FOBT/FIT is probably more effective overall on the population level. Unlike a colonoscopy, it is reasonable to repeat the FOBT/FIT every 1-2 years. Screening colonoscopies are usually done at intervals of 10 years. So imagine if you start doing colon cancer screening in 2023. In 2024, you start to develop cancer. If you are screening by colonoscopy, you will have to wait until 2033 to find it, unless you have symptoms in which case you are in trouble! (The whole idea of screening is you don’t wait for symptoms.) Also it is important to remember that in the real world, people hate colonoscopies, health care is not always perfectly accessible, life gets in the way etc so it could be even more delayed. But if you are doing your FIT/FOBT every 1-2 years you will likely detect it fairly quickly. People are much more likely to actually go through with FIT/FOBT testing compared to colonoscopies. Then when you get the positive FIT/FOBT result, you’d be sent for a colonoscopy (or some other equivalent) for the confirming diagnosis.
If you are being recommended colonoscopy as a regular-risk person on the basis of age, your health system is not serving you well. Compared to colonoscopies, regular FOBT or FIT testing has an insignificant risk of complications (bowel perforations, death etc) and is easily conducted at home without the unpleasant “preparation” required of a scope. If done every 2-3 years they are at least as (and maybe more) effective at detecting cancer compared to a scope.
What is FOBT and FIT testing?
@[email protected] shared a great link for FIT. From the same website: FOBT = Fecal Occult Blood Test
FIT/FOBT: low-cost, low-barrier, easy and 100% safe test done by the patient themselves at home
Colonoscopy: expensive, resource-intensive, onerous, invasive, time-consuming and while usually safe there are complications up to and including death
Even though an individual colonoscopy is more sensitive than an individual FOBT/FIT, regular use of FOBT/FIT is probably more effective overall on the population level. Unlike a colonoscopy, it is reasonable to repeat the FOBT/FIT every 1-2 years. Screening colonoscopies are usually done at intervals of 10 years. So imagine if you start doing colon cancer screening in 2023. In 2024, you start to develop cancer. If you are screening by colonoscopy, you will have to wait until 2033 to find it, unless you have symptoms in which case you are in trouble! (The whole idea of screening is you don’t wait for symptoms.) Also it is important to remember that in the real world, people hate colonoscopies, health care is not always perfectly accessible, life gets in the way etc so it could be even more delayed. But if you are doing your FIT/FOBT every 1-2 years you will likely detect it fairly quickly. People are much more likely to actually go through with FIT/FOBT testing compared to colonoscopies. Then when you get the positive FIT/FOBT result, you’d be sent for a colonoscopy (or some other equivalent) for the confirming diagnosis.
Fecal immunochemical test
https://www.ccalliance.org/screening-prevention/screening-methods/fecal-immunochemical-test