The head of the Center for Disease Control chooses FIT as his personal Colon Cancer screening approach

By Marcus Plescia, MD, MPH
Former Director of CDC’s Division of Cancer Prevention and Control

Last year I turned 50. Time to get tested for colorectal (colon) cancer!

If you read our recent Vital Signs report, you know colorectal cancer is the second leading cancer killer of men and women in the United States, after lung cancer. And about 23 million people—that’s 1 in 3 adults—between 50 and 75 have not been tested appropriately.

As a physician, I’ve taken care of people who’ve had colon cancer; it’s serious. As director of CDC’s Division of Cancer Prevention and Control, I lead a national program that promotes colorectal cancer screening. If ever there was a time to step up to the plate, this was it. I told myself, ‘It’s time to practice what you preach!’

The three recommended colorectal cancer screening tests are—

• high-sensitivity stool tests, including the fecal immunochemical test (FIT);
• the seldom-done flexible sigmoidoscopy;
• and the test done most frequently—colonoscopy.

I took a good hard look at each of them.

I understand the science, have good insurance, and can get any test I want. For some time now, I’ve tried to make the argument that colonoscopy is not the only colon cancer screening test option. And if I could do anything to help people understand that there are effective test options, I would.

There is appeal to the argument that with colonoscopy, you can see the inside lining of the colon, so it can be a very thorough checkup, with polyp removal if necessary. But the FIT has advantages, too.

I opted for the FIT because it was a very reasonable option, one I’m comfortable with. It met my needs perfectly. I wanted to lead by example—it’s one thing to say that it’s a very effective colorectal cancer screening test and recommend it to others … another to do it yourself. But that’s not the only reason I chose FIT. I also thought, ‘Boy, this is pretty easy!’ I got the test in the mail, it took about five minutes, nothing unpleasant about it, and I sent it back.

I liked having options, and that I could tailor what test I did to what my preferences were. I liked the idea that it was convenient, and that I didn’t have to take a day off of work. I’m due for my next FIT in April, and I’ll continue to think about and consider the test options every time I’m due for screening. At some point I may get a colonoscopy, though probably not for awhile. I really believe what we say: the best screening test is the one that gets done!