Key Points:
- Dr. Theodore R. Levin emphasizes the importance of stool-based testing such as the fecal immunochemical test (FIT) as a first-line option, not just an alternative to colonoscopy, for colorectal cancer (CRC) prevention, especially in large-scale screening programs.
- Recent studies indicate that FIT not only detects but potentially reduces the incidence of and mortality from colorectal cancer. Comparative data suggest that FIT may achieve nearly the same mortality reduction as colonoscopy but with fewer required procedures.
- A mailed FIT program significantly increased screening compliance, with a marked reduction in CRC incidence and mortality. This approach also helped narrow the screening gap across different demographic groups.
- While mt-sDNA testing offers higher sensitivity compared to FIT, it has lower specificity, higher costs, and is recommended as a second-tier test. Simulations show that annual FIT may be more effective and cost-efficient than mt-sDNA administered every three years.