Abnormal Fecal Immunochemical Test (FIT) Result Frequently Asked Questions

An abnormal FIT result does not necessarily mean that you have colorectal cancer or pre-cancerous polyps, but it does mean that additional testing is needed. Polyps are abnormal growths on the lining of the colon or rectum that can sometimes turn into cancer over time.

Your family doctor or nurse practitioner will usually recommend that you get a colonoscopy. If you do not have a family doctor or nurse practitioner, please call Cancer Care Ontario to talk about next steps. You can call us toll-free at 1-866-662-9233 from Monday to Friday, 8:30 a.m. to 5 p.m.

ColonCancerCheck, Ontario’s colorectal cancer screening program, recommends that you have a colonoscopy within 8 weeks of an abnormal FIT result.

Only a colonoscopy can tell you if you have colorectal cancer.

• FIT cannot tell the difference between bleeding from colorectal cancer and bleeding for other reasons, such as hemorrhoids or menstruation (your period).
• An abnormal FIT result could mean you have colorectal cancer, even if you feel healthy or no one else in your family has the disease.
• Even if you have had normal FIT results in the past, a new abnormal result means something in your colon may have changed and you need a colonoscopy to find out more.

A colonoscopy is an exam that allows a doctor to look at the lining of your entire colon using a long, flexible tube with a tiny camera on the end. During the colonoscopy, the doctor can also take biopsies (tissue samples) or remove polyps (small growths that form on the lining of the colon or rectum).

A colonoscopy can help protect your health. When colorectal cancer is caught early, 9 out of 10 people with the disease can be cured. If colorectal cancer is diagnosed later, it can be treated, but curing it is less likely.

A colonoscopy is safe and it usually takes less than 30 minutes. You can get medication (a sedative and a pain killer) to make you comfortable during the colonoscopy.

The day before your colonoscopy

• You must get ready for your colonoscopy the day before. You will have to empty out your colon by taking a laxative (called “bowel preparation”). The laxative will ensure that your colon is completely empty and clean so the doctor can see inside your colon clearly and does not miss anything. Before your colonoscopy, you will get instructions about what laxative to take, any medications you should stop taking, and what you can eat and drink.

The hours after your colonoscopy

• After your colonoscopy, you will be watched closely while the sedative (a medication used to make you more comfortable) wears off. Colonoscopy is a day test and you will need someone to take you home – you cannot drive a car, or take public transit alone after being sedated.
• You may feel a little bloated or have gas for a few hours. After being sedated, slowly doing more activities, such as walking, will help you pass the gas. You will also be able to start eating and taking your medications as usual. It is normal to see a small amount of blood in your first stool (poop).

You will get your colonoscopy results before you leave the hospital or clinic from the doctor who did your colonoscopy. Your family doctor or nurse practitioner will also get a copy of your results.  

Normal colonoscopy

• If you had an abnormal FIT result and then a normal colonoscopy result, you can wait 10 years before getting checked again for colorectal cancer. Ten years after your colonoscopy, you should start getting checked again with FIT every 2 years.

Abnormal colonoscopy

• Your colonoscopy may find polyps (small growths that form on the lining of the colon or rectum), cancer or other diseases of the colon. In most cases, all polyps can be removed during your colonoscopy.
• Before you leave the hospital or clinic, the doctor who did your colonoscopy will tell you whether or not polyps were found and removed. Any polyp or tissue removed during your colonoscopy will be sent to the lab for testing. The doctor who did your colonoscopy will get a final report in a few weeks. Your family doctor or nurse practitioner will also get a final report. Based on the results in your final report, your family doctor or nurse practitioner will talk to you about next steps, which may include getting more tests or treatments.
• If cancer was found or is suspected, additional tests are required. Sometimes the doctor who did your colonoscopy can tell you right away whether you have cancer, but sometimes you need more tests before knowing for sure.

Surveillance

• If you have certain types of polyps removed during your colonoscopy (called “polypectomy”), you may be at increased risk of getting colon cancer and may need another colonoscopy in the future. This is called “post-polypectomy surveillance.” Whether or not you need post-polypectomy surveillance depends on the size and type of polyps found during your first colonoscopy.
• Any polyp or tissue removed during your colonoscopy will be sent to the lab to be tested.
• The doctor who did your colonoscopy will tell you your test results and next steps. This may mean that you should have another colonoscopy in the future or get screened with FIT in a few years.

Colonoscopy is a safe test and complications do not happen often. Complications may include:

• a reaction to the medication (a sedative) used to make you more comfortable
• a very small risk of puncturing (making a hole) of the colon or rectum, which may need to be fixed with surgery
• bleeding caused by the removal of polyps (small growths that form on the lining of the colon or rectum)