The article from Medscape, titled “1 in 10 Stool-Based CRC Tests Can’t Be Processed,” discusses a significant issue with fecal immunochemical tests (FIT) used for colorectal cancer (CRC) screening. Approximately 10% of these tests, conducted by a safety-net health system, were found to contain unsatisfactory samples that couldn’t be processed. The study, led by Rasmi Nair, MBBS, PhD, from UT Southwestern Medical Center, highlights the need for better follow-up systems for unsatisfactory FIT results.
Key findings and concerns include:
- Less than half of the patients with unacceptable FIT samples completed a follow-up test within 15 months.
- Unsatisfactory tests often result from inadequate or old specimens, incomplete labeling, or broken/leaking containers.
- The study emphasizes the need for comprehensive patient education and system improvement strategies to enhance screening effectiveness.
The article also notes that FIT is a recommended option for annual CRC screening for adults aged 45-75 years by the US Preventive Services Task Force (USPSTF). It’s particularly important for uninsured, lower-income individuals, as it’s less expensive and more accessible than a colonoscopy. However, its effectiveness depends on the patient returning a satisfactory sample and clinician follow-up when the test is abnormal.
The study, published in Cancer Epidemiology, Biomarkers & Prevention, analyzed 56,980 individuals aged 50-74 years who underwent initial FIT screening from 2010 to 2019. Of these, 10.2% were deemed unsatisfactory by the processing lab. The article also discusses the challenges and potential solutions to improve the FIT screening process, emphasizing its cost-effectiveness and ease compared to colonoscopy.