Colorectal Cancer Hub

General Details of Digital Diagnostic Approaches

Digital diagnostics in healthcare is a blossoming area that covers a wide variety of diagnostic tests and analysis that continues to expand in new ways. In fact, digital diagnostics can include blood tests, biopsies, imaging, genetic testing, and remote monitoring of vital signs and organ function. Artificial intelligence (AI) is increasingly being used to process and analyze digital diagnostic testing, which generates multiple benefits of reducing the percentage of errors in test results, decreasing some tedious test interpretation tasks, and increasing face-to-face time for patients with their healthcare professionals. In addition, expanding the use of digital diagnostics can help create more equitable care for marginalized patients both in the U.S. and around the world.

Disparities of Digital Diagnostic Approaches

Some medical research studies have analyzed the link between diagnostic errors and health care disparities. One example of these studies includes increased likelihood of misdiagnosis using genetic testing with patient diagnostic tools that were created with less diverse patient populations. Another example includes a research study that concluded that Black patients were more likely to be underdiagnosed with depression compared to their white counterparts in cases when they visited their primary care clinics for mental health concerns.

Why This Matters

Diagnostic errors that lead to underdiagnosis and misdiagnosis of patient conditions may lead to reduced quality of life and even higher death rates for some conditions. Standardized digital diagnostic approaches can be a powerful tool in moving toward equitable medical diagnostic testing and care for all. As diagnostic data for all patient populations becomes more readily available, analysis and, in turn, patient diagnosis and care will become more refined for improved care no matter patient gender, geographic location, socioeconomic status, or racial or ethnic background. A wide range of medical conditions can benefit from more timely and accurate diagnosis including conditions such as lung cancer, breast cancer, genetic abnormalities discovered during prenatal care, and heart defects and conditions.

Call to Action

Digital diagnostic approaches are essential for moving toward equitable care for all patients. Any patient advocates who want to advocate for improved care can write to their congresspeople to support standardized diagnostic testing for all. During your next visit to your healthcare professional, ask them how digital diagnostics are assisting them in patient care.

Brooke Whitaker, DCLS, MLS(ASCP)cm is a doctor of clinical laboratory science. You can find her on Twitter: @BrookeW74021416.

General Details of Fecal Immunochemical Test

A fecal immunochemical test (FIT) checks for hidden blood in the form of hemoglobin in stool samples. Though the FIT test is used most frequently in screening for colorectal cancer, the test can also discover gastrointestinal bleeding caused by conditions such as hemorrhoids and ulcers. Overall, the fecal immunochemical test is a reliable screening test, but additional testing with other test methods will usually be used for diagnosis in cases of abnormal test results. When the lab professional prepares the FIT test, the stool sample will be combined with a liquid. Then the combination of the stool sample and liquid are placed in a device with antibodies that bind with hemoglobin if it exists within the stool sample. It’s also important to note that the fecal immunochemical test only detects hemoglobin that is fully intact from the lower intestinal system. The FIT test will not detect hemoglobin from the upper gastrointestinal system that has been partially digested. FIT test stool samples can usually be collected at home and then be sent to a doctor or laboratory for analysis, and they can sometimes be purchased over the counter to be performed at home by the patient. The U.S. Preventive Services Task Force (USPSTF) recommends colorectal cancer screening start at age 45, and the FIT test is frequently chosen to meet the recommendation in individuals not at high-risk of colon cancer.

Disparities of Fecal Immunochemical Test

A recent study showed that some population groups show lower rates of preventive colorectal cancer screening at 47 percent for Hispanic Americans, 48 percent for Native Americans, 52 percent for Asian Americans, 59 percent for Black Americans, 47 percent for low-income groups, and 25 percent for uninsured patients. Fecal immunochemical testing is an excellent option for screening due to FIT testing being non-invasive, lower cost, and ease of the patient collecting their stool sample at home.

Why This Matters

Early onset colorectal cancer rates have been on the rise in recent years, and this fact makes annual fecal immunochemical testing starting at age 45 vital for all patients. Several patient groups including Hispanic Americans, Asian Americans, Black Americans, low-income patients, and uninsured patients could benefit from focused efforts to improve their colorectal cancer screening rates. Early detection of colorectal cancer is important for treatment to lead to better health outcomes and to save more patient lives. Another recent published study showed that the use of a series of text message reminders to patients about their fecal immunochemical test improved completion rates by almost 20 percent. It’s also of interest in this specific study that 90 percent of the study participants were Black patients.

Call to Action

If you are a patient 45 years of age or older, you should receive annual fecal immunochemical testing. Make sure to ask your healthcare professional about completing a fecal immunochemical test as part of your annual health checkup. If you have a family history of colorectal cancer, this annual screening should start before age 45, and you should ask your healthcare professional when your screening should start. If you have a hectic life and can use some reminders to help you complete your FIT, ask your healthcare professional or clinic if they can send you text message reminders or email reminders to keep you on track for returning your test. Fecal immunochemical testing is an essential part of preventive health screening for patients. Make sure to ask your healthcare professional if you have additional questions about this test.

Brooke Whitaker, DCLS, MLS(ASCP)cm is a doctor of clinical laboratory science. You can find her on Twitter: @BrookeW74021416.