Performance of Repeated Fecal Immunochemical Testing for Colorectal Cancer Screening

The fecal immunochemical test (FIT) is receiving increasing attention as an effective method of colorectal cancer screening. However, few data are available on the yield of repeated rounds of FIT screening.

To prospectively evaluate participation rates, positivity rates, and cancer yields from repeated FIT screening, investigators invited 2959 people aged 50 to 74 in a region of Italy to participate in screening using a quantitative FIT. Those eligible were invited to participate in three subsequent rounds of screening during 7 years.

Overall, 73% of the original invited population participated in at least one test, 48% participated in all four tests, and the adherence rate for each round ranged from 56% to 63%. The positivity rate with a cutoff of 100 ng hemoglobin/mL buffer remained consistent in the four rounds of screening (4.3%, 4.2%, 3.7%, and 4.4%). The detection rate for advanced neoplasia was 1.5% in the first round and 1.3% in each of the subsequent three rounds. The cumulative detection rate for advanced neoplasia (advanced adenomas or cancer) was 3.5%.