NEW data has revealed that screening for colorectal cancer (CRC) using faecal immunochemical tests (FIT) is significantly associated with a reduction in mortality rates. FIT is a widely used method for CRC screening but there is insufficient evidence demonstrating its effectiveness. Researchers conducted a nested case-control study to evaluate whether FIT screening reduced the risk of CRC mortality.
The study analysed data from 10,711 individuals in two large integrated health systems in the USA, which are composed of racially, ethnically, and socioeconomically members. Participants were eligible if they were aged 52–85 and had died from colorectal adenocarcinoma between 2011–2017. These cases were matched with controls that were alive and CRC-free on the case’s diagnosis date, creating a robust comparative cohort. During the study period, 63.5% of the controls completed at least one FIT, with a cumulative positivity rate of 12.6%. The data analysis, spanning from January 2002 to December 2017, leveraged long-term FIT screening outreach programs.
Results revealed that those who completed one or more FIT screenings within the five-year period prior to diagnosis had a 33% lower risk of dying from CRC. Notably, the risk reduction was even more pronounced for cancers located in the left colon and rectum, with a 42% lower mortality risk compared to those who did not undergo FIT screening. The study also highlighted that the benefits of FIT screening were consistent across various demographic groups. Non-Hispanic Asian individuals experienced a 63% reduction in CRC mortality risk, non-Hispanic Black individuals a 42% reduction, and non-Hispanic White individuals a 30% reduction.
The findings support the use of FIT as an effective population-based screening strategy for colorectal cancer. Given its non-invasive nature and ease of administration, FIT can be a valuable tool in early CRC detection, potentially reducing the need for more invasive procedures like colonoscopies if used appropriately. The study’s authors call for further research to confirm these findings and to explore the potential of FIT in broader population health strategies. Early identification of CRC risk through simple tests like FIT could lead to more timely and targeted interventions, ultimately saving lives.
Laith Gergi, EMJ
Reference
Doubeni CA et al. Fecal immunochemical test screening and risk of colorectal cancer death. JAMA Netw Open. 2024;7(7):e2423671.
