FIT Screening May Be as Effective as Colonoscopy in Detecting Familial Colorectal Cancer

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Fecal immunochemical testing (FIT) may be just as effective as colonoscopies in being able to detect colorectal cancer risk in first-degree relatives of diagnosed patients, according to a recent study published in Gastroenterology.

Researchers led by Enrique Quintero, MD, PhD, and Marta Carrillo, MD, of the Hospital Universitario de Canarias in Spain conducted a prospective randomized trial of 1,918 first-degree relatives of patients with colorectal cancer who were randomly split to receive either single colonoscopy or three FITs (once a year for three years).

They found that repeated FIT screening was able to detect all instances of colorectal cancer in these patients, as well as 61 percent of advanced adenomas. In terms of diagnostic yield and tumor staging, this proved equivalent to one-time colonoscopy screening However, colonoscopy surpassed FIT in detecting non-advanced adenomas.

“There is evidence showing underutilization of colonoscopy at the recommended intervals among asymptomatic first-degree relatives of patients,” the authors noted. “FIT could potentially offer a less invasive option for these patients.”

Current practice guidelines recommend more intensive screening for familial colorectal cancer compared to the general population, with a routine colonoscopy every five years starting at the age of 40.

Tailored Intervention Fails to Improve CRC Screening Rates
Fecal immunochemical testing may be as effective as colonoscopies.

Fecal immunochemical tests (FIT) may be as effective as colonoscopies when it comes to detecting colorectal cancer among first-degree relatives of patients with colorectal cancer, according to a new study in Gastroenterology, the official journal of the American Gastroenterological Association.

"In our study, repeat FIT screening detected all colorectal cancers in asymptomatic first-degree relatives of patients with colorectal cancer," said lead study authors Enrique Quintero, MD, PhD, and Marta Carrillo, MD, from Hospital Universitario de Canarias, Tenerife, Spain. "These findings suggest that FIT screening should potentially be considered for familial screening, especially in populations where colonoscopy capacity is limited and/or compliance with colonoscopy is a concern."

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