Interval Colorectal Cancer Incidence Among Subjects Undergoing Multiple Rounds of Fecal Immunochemical Testing

Area of Science:

• Oncology
• Gastroenterology
• Public Health

Background:

• Colorectal cancer (CRC) screening is crucial for early detection.
• Guaiac fecal occult blood tests (gFOBT) have known interval cancer rates.
• Data on interval cancers after fecal immunochemical test (FIT) screening are limited.

Purpose of the Study:

• To analyze interval cancer rates in a pilot FIT-based CRC screening program.
• To compare outcomes of screen-detected CRC (SD-CRC) versus non-SD-CRC.
• To assess FIT sensitivity for CRC detection.

Main Methods:

• Analysis of data from a biennial FIT-based CRC screening program (2006-2014) in the Netherlands.
• Inclusion of 18,716 participants screened over four rounds.
• Linking screening data with the Netherlands Cancer Registry for outcomes and survival analysis.

Main Results:

• CRC was detected in 261 participants; 116 were SD-CRC and 145 were non-SD-CRC.
• The FIT interval cancer proportion after three rounds was 23%, indicating 77% FIT sensitivity.
• Survival rates were significantly higher for SD-CRC (89%) and FIT interval cancers (81%) compared to colonoscopy interval cancers (44%) and nonparticipants (60%).

Conclusions:

• FIT screening demonstrates a lower proportion of interval cancers compared to gFOBT.
• FIT screening is a sensitive method for CRC detection.
• Early detection through FIT screening is associated with improved patient survival.