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In a patient undergoing colorectal cancer (CRC) screening, how often does a positive fecal immunochemical test (FIT) followed by a negative colonoscopy suggest a cancer proximal to the colon? To address this issue, Dutch researchers used data from a CRC screening registry that included about 2 million middle-aged patients (age range, 55–75) who were screened with quantitative FIT tests (threshold for positivity, 47 µg hemoglobin/g of feces).
Findings were as follows:
About 3% of patients were FIT-positive with negative colonoscopy, 3% were FIT-positive with advanced neoplasia (advanced adenoma or colorectal cancer), and 94% were FIT-negative.
The 3-year incidence of cancers proximal to the colon was slightly (but statistically significantly) h…