Colorectal cancer screening adherence is higher with fecal immunochemical tests than guaiac-based fecal occult blood tests: A randomized, controlled trial

Abstract

Objectives Determine whether colorectal cancer screening adherence is greater with fecal immunochemical tests (FIT) or guaiac-based fecal occult blood tests (gFOBT). Methods We used electronic health records to identify 3869 New Mexico Veterans Affairs Health Care System primary care patients due for screening in 2008 for whom fecal blood testing was appropriate. We invited randomly selected patients by mail to participate in a study comparing FIT and gFOBT. We randomly allocated 404 subjects to receive FIT ( n = 202) or gFOBT ( n = 202) by mail. We determined the proportion of subjects completing testing within 90 days of agreeing to participate in the study. We also used multivariate logistic regression to evaluate screening completion, adjusting for age, gender, race/ethnicity, clinic site, previous gFOBT testing, and co-morbidity. Results Screening adherence was higher with FIT than gFOBT (61.4% vs. 50.5%, P = 0.03). The adjusted odds ratio for completing FIT vs. gFOBT was 1.56, 95% CI 1.04, 2.32. Conclusion In a clinic setting of patients who were due for colorectal cancer screening, adherence was significantly higher with FIT than gFOBT.