Reduced Incidence of Colorectal Cancers With Repeated Screening With Fecal Immunochemical Tests

Abstract

Background and AimsScreening for fecal occult blood test with fecal immunochemical tests (FIT), a widely utilized test for colorectal cancer (CRC) screening in Japan, has reduced the mortality from CRC in the country. This study aimed to evaluate the importance of repeated FIT screening by comparing the incidence of CRC in patients undergoing initial and repeated screening.MethodsParticipants aged ≥40 years in Saga, Japan, were invited to undergo a 2-day FIT. FIT was analyzed by latex agglutination immune-turbidimetry. The presence of CRC in FIT positive (≥100ng/mL) subjects was verified by colonoscopy, and CRC incidence rates calculated.ResultsFrom 2005 to 2007, 55,595 individuals were invited to undergo CRC screening, including 47,168 undergoing repeated and 8427 undergoing initial screening. Of the 5832 FIT-positive subjects, 4615 were assessed by colonoscopy and 114 subjects were diagnosed as having CRC. Of these 114 patients, 67 had early and 47 had advanced CRC. The incidence of CRC was 63% lower in the repeated than in the initial screening group (P < .0001). The rate of curative endoscopic treatment for early CRC was higher in the repeated than in the initial screening group. Overall survival was longer in screened subjects than in those who visited hospitals with clinical symptoms.ConclusionsRepeated annual CRC screening with FIT reduced the incidence of CRC compared with initial screening. Background and AimsScreening for fecal occult blood test with fecal immunochemical tests (FIT), a widely utilized test for colorectal cancer (CRC) screening in Japan, has reduced the mortality from CRC in the country. This study aimed to evaluate the importance of repeated FIT screening by comparing the incidence of CRC in patients undergoing initial and repeated screening. Screening for fecal occult blood test with fecal immunochemical tests (FIT), a widely utilized test for colorectal cancer (CRC) screening in Japan, has reduced the mortality from CRC in the country. This study aimed to evaluate the importance of repeated FIT screening by comparing the incidence of CRC in patients undergoing initial and repeated screening. MethodsParticipants aged ≥40 years in Saga, Japan, were invited to undergo a 2-day FIT. FIT was analyzed by latex agglutination immune-turbidimetry. The presence of CRC in FIT positive (≥100ng/mL) subjects was verified by colonoscopy, and CRC incidence rates calculated. Participants aged ≥40 years in Saga, Japan, were invited to undergo a 2-day FIT. FIT was analyzed by latex agglutination immune-turbidimetry. The presence of CRC in FIT positive (≥100ng/mL) subjects was verified by colonoscopy, and CRC incidence rates calculated. ResultsFrom 2005 to 2007, 55,595 individuals were invited to undergo CRC screening, including 47,168 undergoing repeated and 8427 undergoing initial screening. Of the 5832 FIT-positive subjects, 4615 were assessed by colonoscopy and 114 subjects were diagnosed as having CRC. Of these 114 patients, 67 had early and 47 had advanced CRC. The incidence of CRC was 63% lower in the repeated than in the initial screening group (P < .0001). The rate of curative endoscopic treatment for early CRC was higher in the repeated than in the initial screening group. Overall survival was longer in screened subjects than in those who visited hospitals with clinical symptoms. From 2005 to 2007, 55,595 individuals were invited to undergo CRC screening, including 47,168 undergoing repeated and 8427 undergoing initial screening. Of the 5832 FIT-positive subjects, 4615 were assessed by colonoscopy and 114 subjects were diagnosed as having CRC. Of these 114 patients, 67 had early and 47 had advanced CRC. The incidence of CRC was 63% lower in the repeated than in the initial screening group (P < .0001). The rate of curative endoscopic treatment for early CRC was higher in the repeated than in the initial screening group. Overall survival was longer in screened subjects than in those who visited hospitals with clinical symptoms. ConclusionsRepeated annual CRC screening with FIT reduced the incidence of CRC compared with initial screening. Repeated annual CRC screening with FIT reduced the incidence of CRC compared with initial screening.