Comparative Performance of Common Fecal Immunochemical Tests : A Cross-Sectional Study

Area of Science:

• Gastroenterology
• Oncology
• Diagnostic Medicine

Background:

• Fecal immunochemical tests (FITs) are widely used for colorectal cancer (CRC) screening.
• Limited data exist to guide the selection of specific FIT brands for optimal screening.

Purpose of the Study:

• To compare the performance characteristics of five commonly used FITs for colorectal cancer screening.
• To evaluate sensitivity and specificity of different FITs using colonoscopy as the reference standard.

Main Methods:

• A cross-sectional study involving 3761 participants aged 50-85 undergoing colonoscopy.
• Participants completed five different FITs; performance was assessed against colonoscopy findings for advanced colorectal neoplasia (ACN).

Main Results:

• Test positivity rates varied four-fold across FITs, from 3.9% to 16.4%.
• Sensitivity for ACN ranged from 10.1% to 36.7%, and specificity from 85.5% to 96.6%.
• Significant differences in sensitivity and specificity were observed between most FIT brands.

Conclusions:

• Fecal immunochemical tests (FITs) exhibit variable performance in detecting advanced colorectal neoplasia.
• Different FIT brands are not interchangeable and test selection may impact screening effectiveness.