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News

Yield of population-based fecal immunochemical test screening

This month's American Journal of Gastroenterology performs a consecutive third round of FIT screening in a population-based colorectal cancer screening trial.

News image

Fecal immunochemical test (FIT) screening for colorectal cancer requires timely successive rounds for an optimal preventive effect.

However, data on attendance and trend in yield over multiple rounds of FIT screening are limited.

Dr Atija Kapidzic and colleagues from the Netherlands conducted a consecutive third round of FIT screening in a population-based colorectal cancer screening trial.

Average-risk subjects aged 50–74 years were approached for 3 rounds of 1-sample FIT (OC-sensor) screening.

Subjects with a hemoglobin level ≥50 ng/ml (≥10 μg Hb/g) feces were referred for colonoscopy.

73% of all eligible subjects participated in at least 1 of 3 rounds
American Journal of Gastroenterology

Subjects with a positive FIT in previous rounds were not re-invited for FIT screening.

In the first round, 7,501 subjects were invited.

The team noted that the participation rate was 63% in the first round, 63% in the second round, and 68% in the third round.

In total, 73% of all eligible subjects participated in at least 1 of 3 rounds.

The researchers found that positivity rate was significantly higher in the first round compared with the second, and third screening rounds.

The team noted that detection rate of advanced neoplasia declined from the first round to subsequent rounds.

The research team observed that positive predictive value for advanced neoplasia was 41% in the first screening round, 33% in the second screening round, and 24% in the third screening round.

Dr Kapidzic's team concludes, "Repeated biennial FIT screening is acceptable with increased participation in successive screening rounds, and more than 70% of all eligible subjects participating at least once over 3 rounds."

"The decline in screen-detected advanced neoplasia over three screening rounds is compatible with a decreased prevalence of advanced neoplasia as a result of repeated FIT screening."

"These findings provide strong evidence for the effectiveness of FIT screening and stress the importance of ongoing research over multiple screening rounds."

Am J Gastroenterol 2014; 109: 1257–1264
15 August 2014

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