FIT vs. Colonoscopy in Familial Colorectal Cancer Screening

In the first randomized, controlled trial of fecal immunochemical test (FIT) versus colonoscopy in patients with a family history of colorectal cancer (CRC), investigators enrolled asymptomatic, first-degree relatives aged ≥40 years or 10 years younger than the youngest confirmed CRC case in the family.

Among 782 participants in the colonoscopy group, the overall adenoma detection rate was 18.9% and 52.2% of patients were aged <50 years. In the intention-to-screen analysis, detection of advanced neoplasia (advanced adenoma or cancer) was 5.6% in the colonoscopy group and 4.2% in the FIT group (odds ratio, 1.41; 95% confidence interval, 0.88–2.26). In the per-protocol analysis, the rates were 5.8% and 3.9%, respectively (OR, 1.56; 95% CI, 0.9…