Intest Res.  2010 Dec;8(2):126-134. 10.5217/ir.2010.8.2.126.

The Significance of Fecal Immunochemical Test to Screen for Colorectal Cancer in National Cancer Screening Program

• Lim JU
• Bae NY
• Song WK
• Cha JM
• Lee JI

• KMID: 2284930
• DOI: http://doi.org/10.5217/ir.2010.8.2.126

Abstract

BACKGROUND/AIMS
Colorectal cancer (CRC) is one of the major causes of death and poses a major public health concern. The National CRC Screening Programme (NCSP) provides annual CRC screening using a fecal occult blood test for individuals >50 years of age since 2004. The purpose of the current study was to determine the outcomes and efficacy of a fecal immunochemical test (FIT) based on the NCSP in a quality-controlled university hospital setting.
METHODS
We retrospectively reviewed the medical records and a standardized questionnaire from the NCSP of 3,852 individuals who underwent a FIT between March and December 2009. All of the subjects submitted a stool specimen for a FIT, while a double-contrast barium enema or colonoscopy was performed as a confirmatory examination for FIT-positive individuals. The CRC screening rate and rate of detection colorectal adenomas, advanced adenomas, and colorectal cancers by FIT were evaluated.
RESULTS
The CRC screening rate with FIT was very high (72.3%), but the positive rate of detection by FIT was only 1.3%. The rate of detection for colorectal cancers, adenomas, and advanced adenomas by FIT was 0.08%, 0.39%, and 0.13%, respectively. The quantitative values of FIT in individuals with colorectal adenomas and cancers were significantly higher than other colorectal diseases. Men (P=0.001) and elderly individuals (P=0.039) were significantly more common in the FIT-positive group than the FIT-negative group. Approximately 28% of the subjects with FIT-positive tests did not receive a confirmatory examination.
CONCLUSIONS
Although the FIT had a low rate of detection, the FIT was a useful screening tool for detection of CRC in the NCSP. It will be important to increase CRC screening rates and confirmatory examination rates.

Keyword

Colorectal Cancer; Fecal Immunochemical Test; Screening; National Colorectal Cancer Screening Programme

MeSH Terms

Adenoma
Aged
Barium
Cause of Death
Colonoscopy
Colorectal Neoplasms
Early Detection of Cancer
Enema
Humans
Male
Mass Screening
Medical Records
Occult Blood
Public Health
Retrospective Studies
Surveys and Questionnaires
Barium