Colonoscopy More Likely to Detect Advanced Adenomas than Fecal Immunochemical Testing

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(ChemotherapyAdvisor) – Advanced adenomas were more likely to be detected in asymptomatic adults randomized to colonoscopy than to fecal immunochemical testing (FIT), according to an interim report in The New England Journal of Medicine published February 23.

However, subjects were more likely to participate in FIT screening (34.2%) than colonoscopy (24.6%; P<0.001), the investigators found. The trial is designed to detect rate of death from colorectal cancer at ten years. Beginning in June 2009, asymptomatic adults 50 to 69 years of age were randomized to one-time colonoscopy (n=26,703) or FIT every two years (n=26,599). The first round of this study was completed in June 2011; anticipated completion of the ten-year follow-up is 2021.

On the baseline screening examination, colorectal cancer was detected in 30 subjects (0.1%) in the colonoscopy group and 33 (0.1%) in the FIT group (OR=0.99). Colonoscopy detected advanced adenomas in 514 subjects (1.9%) and nonadvanced adenomas in 1109 (4.2%); in the FIT group, advanced adenomas were detected in 231 subjects (0.9%) (OR=2.30) and nonadvanced adenomas in 119 subjects (0.4%) (OR=9.80).

“The comparative effectiveness of FIT and colonoscopy for preventing death from colorectal cancer will be assessed at the completion of this ten-year trial,” they concluded.

Abstract

Clinical Trial

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