Patients Prefer FIT-Fecal DNA Testing Over Colonoscopy

Most patients prefer an annual fecal immunochemical test (FIT)-fecal DNA over colonoscopy for colorectal cancer (CRC) screening, a new study revealed.

The findings are published in Clinical Gastroenterology and Hepatology.

In May 2021, the US Preventive Services Task Force (USPSTS) issued new recommendations to lower the CRC age for first screening from 50 years to 45 years, to detect and treat CRC among patients at average risk at younger ages.  The new study used conjoint analysis to help doctors assess complex decision making to better understand patient preference in CRC screening considering the new guidelines.

The researchers conducted the survey among unscreened individuals more than 40 years of age at average risk for CRC to determine the relative importance of screening test attributes, such as modality, effectiveness at reducing CRC risk, and bowel prep. They also performed simulations to determine the preference of each US Multi-Society Task Force (MSTF) on CRC-recommended test. For analysis purposes, the researchers classified the patients into 2 study groups: patients aged 40-49 as newly or soon-to-be eligible for screening, and those older than 50 years of age, who are already eligible for screening.

The study revealed that out of 1,000 participants (40-49, n=456; ≥50, n=544), most patients preferred FIT-fecal DNA over colonoscopy for their screening. Among the 40-49 age group, 34.6% preferred FIT every 3 years; among the group older than 50, 37.3% preferred FIT every 3 years. “When considering only the US MSTF tier 1 tests, most 40-49 (68.9%) and ≥50-year-olds (77.4%; p=0.004) preferred an annual FIT over a colonoscopy every 10 years,” stated the researchers.

The study elaborated the general acceptance of a FIT-fecal DNA over a colonoscopy for CRC screening, irrespective of patient age and risk of colorectal cancer.

“Further research examining CRC screening test preferences among broader populations is warranted to inform and enhance screening programs,” the researchers concluded.

—Priyam Vora

Reference:
Makaroff E, Shergill J, Lauzon M et al. Patient Preferences for Colorectal Cancer Screening Tests in Light of Lowering the Screening Age to 45 Years. Clin Gastroenterol Hepatol. Published on July 20, 2022. DOI: https://doi.org/10.1016/j.cgh.2022.07.012