Fecal Immunochemical Test Screening: Maximizing Success by Minimizing Failure

Area of Science:

• Gastroenterology
• Public Health
• Clinical Medicine

Background:

• Fecal immunochemical testing (FIT) is a key method for colorectal cancer screening.
• Implementing FIT programs, whether opportunistic or mailed, faces practical challenges.
• Ensuring test accuracy and completion rates is crucial for effective screening.

Purpose of the Study:

• To evaluate the rate of unsatisfactory FIT tests in a large safety net hospital system.
• To identify areas for improvement in clinical practice for FIT-based colorectal cancer screening.
• To provide insights into system-level strategies for enhancing FIT success rates.

Main Methods:

• Analysis of data from 56,980 individuals who submitted a FIT test.
• Assessment of test rejection rates within a safety net hospital system.
• Comparison of observed unsatisfactory FIT rates against established benchmarks.

Main Results:

• 10.2% (N = 5,819) of submitted FIT tests were unsatisfactory.
• This rate significantly exceeds the recommended 5% benchmark by the U.S. Multi-Society Task Force.
• The findings indicate substantial room for improvement in FIT implementation and patient adherence.

Conclusions:

• High rates of unsatisfactory FIT tests necessitate a system-level focus on failure prevention.
• Enhanced patient support and clinician engagement are vital for improving FIT completion and reducing rejections.
• Optimizing FIT screening requires addressing practical challenges in test completion and submission.