Interval faecal occult blood testing in a colonoscopy based screening programme detects additional pathology

Area of Science:

• Gastroenterology
• Oncology
• Preventive Medicine

Background:

• Colonoscopic surveillance is crucial for high-risk individuals to prevent colorectal cancer.
• Debate exists regarding optimal surveillance intervals and the detection rate of colorectal cancer within screening programs.

Purpose of the Study:

• To evaluate if an interval fecal occult blood test (FOBT) aids in detecting significant neoplasia during colonoscopic surveillance.
• To assess participant interest in interval screening and identify missed or rapidly developing lesions.

Main Methods:

• Patients in a colonoscopic surveillance program underwent an immunochemical FOBT (Inform).
• Positive FOBT results triggered a follow-up colonoscopy.
• Significant neoplasia included colorectal cancer, large or complex adenomas, high-grade dysplasia, or multiple adenomas.

Main Results:

• Nearly 50% of invited patients (47.8%) completed the FOBT.
• 1.8% of FOBT completers were diagnosed with significant neoplastic lesions, including six colorectal cancers and eight adenomas.
• Positive FOBT results led to the detection of additional pathology.

Conclusions:

• An immunochemical FOBT is a viable tool for interval screening in colonoscopic surveillance programs.
• This approach demonstrates a notable participation rate and detects significant colorectal neoplasia, particularly in patients with a history of polyps.