A Rutgers University study found about half of those who use home-based colon cancer tests fail to retest annually, increasing their risk for undiagnosed cancers. (Photo by Anne-Marie Caruso/New Jersey Monitor)
Home tests for colorectal cancer are increasingly popular, but about half of those who use them fail to follow up as recommended with annual rescreenings, according to a new Rutgers University study.
Dr. Ethan Halm, the lead author of the study published in June, examined a decades’ worth of data from nearly 500,000 patients ages 50 to 65 who used a fecal immunochemical test, or FIT test, to screen for colon cancer at home starting in 2010 or 2011.
Halm found 54% of these patients repeated the at-home screenings in future years; 30% did so inconsistently; and 16% failed to perform a second test. All the patients were part of large healthcare systems in California or Texas that offered tests for free, but Halm found that people in a system that proactively mailed home-screening kits to patients who were overdue for retesting were most likely to repeat annual screenings.
“It’s really about making them broadly available,” Halm, a vice chancellor for population health, told the New Jersey Monitor.
Halm’s study also found that patients who repeated home-based tests were more likely to identify early-stage cancers, which are highly treatable, than those who failed to retest. Those who tested less often, or never did, were more likely to find advanced colorectal cancer, which is far more deadly.
Colorectal cancer is among the most common forms of cancer diagnosed and a leading cause of cancer death, especially among men. Nearly 56,000 people die nationwide from colon cancer, including 1,400 in New Jersey, and mortality rates are highest among Black residents.
Colon cancer death rates have declined nationwide and in New Jersey as screening for the disease has increased. By 2024, more than 77% of residents age 50-75 years were testing for colorectal cancer, according to state data.
Home-based FIT tests are the least expensive and easiest option for most patients, Halm said. The study did not include more recent home-based testing options like Cologuard, which cost hundreds of dollars.
The third and most conclusive option is a colonoscopy, an outpatient procedure that involves several days of preparation and anesthesia. The high cost, a limited number of available clinicians, and many patients’ aversion to this test make it a hard sell for doctors, Halm said.
“There are a lot of people who are squeamish about a colonoscopy. The best test is the test that gets done,” he said, noting that insurance covers all options in New Jersey.
