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The first randomized, controlled trial of guaiac-based fecal occult blood testing for colorectal cancer screening appeared in 1993, establishing that colorectal cancer screening prevents colorectal cancer deaths. Before that, screening studies had established that cancers detected by guaiac screening had an earlier stage distribution compared with symptomatic colorectal cancers. The fecal immunochemical test (FIT) has now replaced the guaiac-based test in much of the world, but this is based on performance characteristics such as higher sensitivity with FIT compared with guaiac and higher adherence rates. Randomized, controlled trials with FIT have not yet been completed.
In this study, researchers evaluated the stage distribution of FIT-det…