Fecal Immunochemical Testing for Patients at High Risk for Colorectal Cancer?

Fecal immunochemical testing (FIT) generally is accepted as appropriate for colorectal cancer (CRC) screening in average-risk patients, but what about high-risk patients? In this meta-analysis, researchers assessed FIT's accuracy in screening asymptomatic high-risk adults with family histories of CRC or personal histories of CRC or advanced adenomas. Twelve studies (that involved 6200 patients) were identified; 6 were considered to have high risk for bias.

Using colonoscopy as the reference standard, pooled estimates of FIT's sensitivity and specificity for detecting CRC were 93% and 91%; corresponding values for advanced neoplasia (i.e., CRC, adenomas ≥10 mm or with ≥25% villous components, or high-grade dysplasia) were 48% and 93%. Assumin…