Fecal Immunochemical Test Screening Is Effective Approach for CRC Screening

Doubeni CA, Corley DA, Jensen CD, et al. Fecal Immunochemical Test Screening and Risk of Colorectal Cancer Death. JAMA Netw Open 7, e2423671 (2024).

Fecal immunochemical testing (FIT) is frequently used for colorectal cancer (CRC) screening; however, benefits of this approach, such as reduced CRC mortality, have not been clearly documented.

Data from two large health systems (n = 10,711) were utilized to determine the risk of CRC-related mortality in patients who participated in a CRC screening program compared with patients who were not screened. Mortality risk for patients undergoing FIT screening (n = 6,101) within 5 years of the CRC diagnosis was compared to patients with CRC who had not undergone FIT screening.

FIT tests were positive in 12.6% of tested patients, and 79.4% of these patients underwent colonoscopy. CRC mortality was 33% lower for patients undergoing FIT screening.

The observed mortality benefit was maintained regardless of age and ethnicity of the patients who were tested; mortality benefit was most pronounced for patients with tumors located in the left colon.

The authors concluded that FIT was an effective approach for CRC screening programs and recommended that patients testing positive undergo colonoscopy.

Surgeons are encouraged to read an ACS Brief review article from 2022, authored by Sandra Kavalukas, MD, FACS, which also reviewed literature on FIT testing.