VANCOUVER, B.C.—In patients with positive results on fecal immunochemical testing, adenoma detection rates have been reported, but less is known about the detection of sessile serrated lesions in the FIT-screened population. Two recent studies of large databases are informative, finding detection rates of approximately 5% to 6%.
The researchers say their data can be helpful in setting quality benchmarks in FIT-based screening programs.
“It’s estimated that approximately 20% to 30% of all colorectal cancers arise from serrated lesions via a pathway that’s distinct from the traditional adenoma carcinoma sequence,” said investigator Natalie Wilson, MD, an internal medicine resident at the University of Minnesota, in Minneapolis. “While the ADR in FIT-positive individuals has been estimated to be about 45% in men and 35% in women, the prevalence of SSLs in these individuals is not well studied.”
Study of VA Database
In a study that received the Lawlor Resident Award at the 2023 annual meeting of the American College of Gastroenterology, Dr. Wilson and her co-investigators examined a nationwide Veterans Affairs database of 51,526 individuals who underwent colonoscopy within 12 months of a positive FIT test (abstract 49). They found at least one clinically significant SSL during colonoscopy in 6.1% of patients overall, including 5.3% of females and 6.5% of males, Dr. Wilson reported.