A study from the Netherlands suggests that individuals aged 75 years or older, who are at the upper age limit for colorectal cancer (CRC) screening, and who had a negative fecal immunochemical test (FIT) but a detectable fecal hemoglobin (f-Hb) concentration during their last screening, are nearly five times more likely to develop CRC compared to those with no detectable f-Hb concentration.
- The study aimed to determine if the risk of interval CRC varied based on the f-Hb concentration of the last FIT.
- Those with a negative FIT in their final CRC screening round were monitored for a CRC diagnosis within 24 months of their negative FIT.
- Out of 305,761 individuals in the study, 661 cases of CRC were identified.
- For every 10,000 negative FIT tests, the interval CRC risk was 21.6 overall. However, for those with a prior f-Hb concentration greater than 0 µg/g, the risk was 65.8.
- Individuals with a prior f-Hb concentration greater than 0 µg/g had a hazard ratio of 4.86 for interval CRC and an odds ratio of 1.45 for advanced stage CRC compared to those without.
- The researchers concluded that determining the upper age limit for CRC screening based on prior f-Hb concentration could help prevent CRC cases and related morbidity. However, they also emphasized that while those with detectable f-Hb might benefit from additional screening, screening older individuals isn’t without risks. Further studies are needed to weigh the pros and cons and determine the best screening approach.