Faecal immunochemical test outside colorectal cancer screening?

Area of Science:

• Gastroenterology
• Oncology
• Diagnostic Biomarkers

Background:

• Faecal immunochemical tests (FITs) are the primary biomarker for colorectal cancer (CRC) screening and mortality reduction.
• Evidence supports FIT use in symptomatic patients and for surveillance post-adenoma resection.

Purpose of the Study:

• To review evidence on FIT for diagnosing CRC in symptomatic individuals.
• To examine FIT's role in surveillance after polyp resection.
• To discuss FIT strategies, recommendations, and their impact.

Main Methods:

• Literature review of diagnostic yield for FIT in symptomatic patients.
• Analysis of FIT strategies: thresholds, brands, frequency, models, and combinations.
• Evaluation of FIT-based surveillance versus endoscopic surveillance.

Main Results:

• FIT demonstrates significant diagnostic yield in symptomatic patients with CRC and colonic lesions.
• Various FIT approaches (thresholds, brands, models) offer flexibility.
• FIT-based surveillance presents a viable alternative to endoscopy post-resection.

Conclusions:

• FIT is a key tool for CRC detection in symptomatic individuals and for surveillance.
• FIT strategies can optimize healthcare resource allocation and CRC prognosis.
• The COVID-19 pandemic highlighted FIT's relevance in reducing colonoscopy demand.