Colorectal Cancer Screening and FIT Testing

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Colorectal Cancer Screening and FIT Testing

**READ AND COMPLETE PRIOR TO ORDERING**

We are thrilled to announce the availability of CRC screening through FIT testing for our patients at St. Vincent’s. However, it is crucial to convey that a positive FIT result is not conclusive. In the event of a positive result, a follow-up colonoscopy is imperative to definitively rule out colorectal cancer or other potential causes.

Please provide the information sheet to the patient and ask them to acknowledge the agreement to be tested and understanding that they will be responsible for covering half of the colonoscopy’s cost if it is needed. The estimated cost of the colonoscopy in Houston is around $1100 through colonoscopy assist, and while we are fortunate to have a grant covering the other half, it is essential for patients to be aware of potential financial responsibilities.

It’s important to emphasize that, as of now, we do not have any funds available for the treatment of colorectal cancer. We encourage patients to consider this information carefully and make informed decisions about their healthcare.

We appreciate your understanding and cooperation as we strive to provide comprehensive care to our community.

Algorithm:

  1. During patient encounter recommend FIT testing to:
    • FIT testing is recommended starting at age 45 to 75 for people at average risk for colorectal cancer. Screening should begin earlier for those with risk factors like family history.
    • For people at average risk, FIT testing should be done every year.
    • If your patient have had a colonoscopy in the past 10 years and it was normal, you can get FIT testing instead of repeat colonoscopies. If their past colonoscopy found precancerous polyps, they will need follow-up colonoscopies as recommended by GI.
    • FIT testing is not appropriate for those with current gastrointestinal symptoms like rectal bleeding, change in bowel habits, or abdominal pain. These people will require colonoscopy.
    • People with a family history of colorectal cancer or certain medical conditions like inflammatory bowel disease may need to start screening earlier and be tested more frequently.
  2. Provide financial responsibility information
    • Provide patient with a printed copy of the flyer explaining potential out of pocket costs for diagnostic colonoscopy if FIT is positive.
    • Please submit the acknowledgement POP UP form on this site.
  3. Log patient information
    • Order FIT Test on Epic, use Z12.11 Screening for colorectal cancer as the diagnostic code
    • Write date of visit and medical record number on the CRC screening tracker spreadsheet when you pick up the FIT test from the lab as this helps us monitor the process and ensure follow up.
  4. Provide FIT test to patient
    • FIT test kits already include instructions for home administration
    • Explain that the test checks for occult blood in stool, which can indicate cancer/polyps
    • Inform patient that they will be notified if the test is positive
  5. Follow up on results: Ordering provider is responsible for notifying patient
  6. if FIT test is positive. After notifying patient please ask front desk to schedule the patient for an appointment in the HCV/CRC Clinic to help patient with diagnostic colonoscopy scheduling.
  7. If FIT is negative, test is repeated yearly until age 75
  8. Results and follow up are documented in Epic EHR

Patient Education Materials:

Spanish
English
Patient Education Text if want to include in Epic

What is a FIT Test?

The Fecal Immunochemical Test (FIT) is a screening tool for detecting early signs of colorectal cancer. It works by identifying tiny amounts of blood in your stool, which can be a sign of polyps or colorectal cancer.

Positive FIT Test Result – What does it mean?

Please remember, a positive FIT test DOES NOT automatically mean you have cancer. It simply means that blood was found in your stool sample. This could be due to polyps, hemorrhoids, or other non-cancerous conditions.

The Next Step: Colonoscopy

If your FIT test result is positive, your physician will likely refer you for a colonoscopy. This procedure allows doctors to examine the inside of your colon for any abnormalities. However, it’s important to note that if you are unable to afford the follow-up colonoscopy, it may not be advisable to take the FIT test.

The colonoscopy is a critical step in confirming or ruling out the presence of colorectal cancer.

What is the cost of a colonoscopy?

A colonoscopy ordered at St Vincent’s could cost between $500-$1,000 out-of-pocket, depending on funds availability.

Remember, early detection is key in successfully treating colorectal cancer. Stay proactive about your health!

If you have any questions or concerns about your FIT test or colonoscopy, please do not hesitate to contact your healthcare provider.

Resources