Key Takeaways:
- Patients with negative fecal immunochemical test (FIT) results, but with values in the upper range, are at a higher risk for advanced neoplasia, including colorectal cancer (CRC), compared to those with lower-range values.
- A study published in the Annals of Internal Medicine highlighted this increased risk.
- The study involved 7,398 participants aged 51 to 79 years, who underwent quantitative FIT testing before a colonoscopy. Most participants (90%) had fecal hemoglobin concentrations below the recommended FIT cutoff value of 17 µg/g.
- The prevalence of advanced neoplasia rose from 6% in participants with hemoglobin concentrations less than 1.7 µg/g to 22% in those with the highest group of FIT-negative results, and up to 51% in those with FIT-positive results.
- At a FIT cutoff value of 17 µg/g, the specificity and negative predictive values were 93%.
- The study suggests a potential benefit from personalized screening intervals based on FIT results, indicating a need for more tailored approaches in CRC screening.
Insights from the Study:
- Risk Stratification in CRC Screening: The findings underscore the importance of considering fecal hemoglobin concentration levels in CRC screening, even when FIT results are negative.
- Personalized Screening Intervals: The study advocates for personalized screening intervals, which could lead to more effective and cost-efficient CRC screening strategies.
- Implications for Future Screening Protocols: These results may influence future CRC screening guidelines, emphasizing the need for more nuanced approaches based on individual risk factors.