Effectiveness of Multiple Consecutive Fecal Immunohistochemical Testing for Colorectal Cancer Screening

Abstract

Objective: The fecal immunohistochemical test (FIT) is a simple colorectal-cancer screening test. There are no recent studies evaluating the benefits of doing more than one a year. Our study aimed to evaluate the effectiveness of performing the test for 3 consecutive days in terms of detecting cancer and advanced adenomas. Methods: This was a single-center retrospective review of records of patients who had daily tests for 3 consecutive days and had at least one positive during the period from 2009-2011. Results: A total of 456 records were reviewed, 410 met the inclusion criteria. Most of the participants were men (95.9%), with the mean age of all the participants being 64.3 (±7.8) years. Regarding the FIT results, 18.8% had positive results on all 3 tests, 20.2% had 2 positive tests, and 61.0% had 1 positive FIT. There were 16 (3.9%) patients in the studied sample that had colon cancer. Their lesions were located predominantly in the distal colon (ratio of distal to proximal: 2:1). The patients with 3 positive FITs had a higher prevalence of advanced adenomas (33.3% vs. 13.4%, respectively; P < .05). Discussion: Our study showed a low concordance between daily consecutive tests results. those patients with more than 1 positive FIT had a higher prevalence of advanced adenoma or adenocarcinoma than patients who had only one. Fewer than 4% of the patients in our study had colon cancer. Prospective studies would be needed to determine the effectiveness of more than 1 annual FIT in colon cancer prevention.