Over 10% of fecal immunochemical tests (FIT), used for routine colorectal cancer (CRC) screening in a safety-net health system, contained unsatisfactory samples that could not be processed. This study was published in the journal Cancer Epidemiology, Biomarkers & Prevention.
Key points from the article include:
- Background of FIT: FIT is a self-collected test that detects hidden blood in the stool. It’s recommended for annual CRC screening among individuals aged 45 to 75. FIT is especially important for uninsured, lower-income individuals, and those from medically underrepresented groups, as it is more accessible and affordable than a colonoscopy or other stool-based tests.
- Study Findings: The study, conducted by Rasmi Nair, MBBS, PhD, and Po-Hong Liu, MD, analyzed 56,980 individuals aged 50 to 74 who underwent FIT screening between 2010 and 2019 within the Dallas-based Parkland Health system. They found that 10.2% of tests were unsatisfactory due to reasons like inadequate specimen, incomplete labeling, sample age, or container issues. Only 40.7% of individuals with unsatisfactory tests received follow-up FIT or colonoscopy screening within 15 months.
- Disparities and Solutions: The study also revealed racial and ethnic disparities in satisfactory FIT completion, with Black patients and Spanish-speaking patients more likely to submit unsatisfactory tests. To improve test completion, the authors suggested solutions like wordless or low-literacy instruction pamphlets, pre-affixed patient labels, and automated systems for identifying and contacting patients with unsatisfactory tests.
- Study Limitations: The study’s applicability might be limited to safety-net systems, and it relied on brief notes from laboratories about unsatisfactory tests. There’s also a possibility that some patients received follow-up care outside the Parkland Health system.
This study highlights the need for improved systems to ensure the effectiveness of FIT as a screening tool for colorectal cancer, especially in safety-net health systems.