FIT Screening Associated With Lower Risk of Death From CRC

Fecal immunochemical test (FIT) screening for colorectal cancer was associated with a reduction in risk of dying from colorectal cancer (CRC), according to a study published in JAMA Network Open.

Researchers aimed to evaluate whether FIT screening correlated with a reduced risk of CRC mortality overall, by cancer location, and within demographic groups.

A nested case-control design was employed within a cohort of screening-eligible individuals in 2 large, racially, ethnically, and socioeconomically diverse health systems with established mailed FIT screening programs. Participants aged 52 to 85 who died from colorectal adenocarcinoma between 2011 and 2017 (cases) were matched 1:8 with controls based on age, sex, health plan membership duration, and geographic area. Data from January 2002 to December 2017 were analyzed.

Participants were categorized based on whether they completed 1 or more FIT screenings in the 5 years before the CRC diagnosis (cases) or a corresponding date (controls). In a cohort of 2,127,128 people, 10,711 participants (1103 cases and 9608 controls) were identified. Among controls, 6101 (63.5%) completed one or more FITs in the prior 10 years, with a 12.6% positivity rate. During the five-year period, 494 cases (44.8%) and 5,345 controls (55.6%) completed FITs. Completing at least 1 FIT was linked to a 33% reduction in CRC death risk (aOR, 0.67; 95% CI, 0.59-0.76) and a 42% lower risk for left colon and rectum cancers (aOR, 0.58; 95% CI, 0.48-0.71). No significant association was found for right colon cancers (aOR, 0.83; 95% CI, 0.69-1.01). The difference between right colon and left colon/rectum cancer estimates was significant (P = .01).

FIT screening reduced CRC mortality risk across non-Hispanic Asian, non-Hispanic Black, and non-Hispanic White individuals, indicating its efficacy in diverse populations. These findings support FIT’s role in population-based CRC screening strategies.

Reference
Doubeni CA, Corley DA, Jensen CD, et al. Fecal immunochemical test screening and risk of colorectal cancer death. JAMA Netw Open. Published online ahead of print July 1, 2024. doi:10.1001/jamanetworkopen.2024.23671