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Updated: May 15, 2026

Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
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Published on: June 8, 2020

Interval Positive Fecal Immunochemical Test Is Associated With Postcolonoscopy Colorectal Cancer in a Screening

Jennifer J Telford1, Edwin Khoo2, Anel Mynzhassarova2

  • 1Cancer Prevention, Screening, and Hereditary Cancer Program, BC Cancer, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|May 13, 2026
PubMed
Summary
This summary is machine-generated.

Individuals with a positive interval fecal immunochemical test (FIT) after colonoscopy face a significantly higher risk of developing post-colonoscopy colorectal cancer (PCCRC). Prompt repeat colonoscopy is recommended for these patients to ensure timely diagnosis and management.

Keywords:
Cancer stageIncomePolicyPopulation

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Area of Science:

  • Gastroenterology
  • Oncology
  • Preventive Medicine

Background:

  • Optimal management for positive interval fecal immunochemical tests (FIT) post-colonoscopy is unclear.
  • This study investigates the risk of post-colonoscopy colorectal cancer (PCCRC) in patients with interval positive FIT within the British Columbia Colon Screening Program (BCCSP).

Purpose of the Study:

  • To determine the risk of PCCRC in patients with an interval positive FIT.
  • To inform management strategies for individuals with unplanned positive FIT results between scheduled screenings.

Main Methods:

  • Retrospective cohort study of 169,117 patients in the BCCSP (November 2013 - December 2021).
  • Compared cumulative colorectal cancer (CRC) incidence among groups: no interval FIT, interval FIT negative, and interval FIT positive.
  • Utilized multivariable Cox proportional hazard models with shared frailty to estimate adjusted hazard ratios (HR) for PCCRC.

Main Results:

  • Of 25,438 patients with interval FIT, 4,001 (15.73%) were positive.
  • The cumulative incidence of PCCRC was significantly higher in the interval FIT positive group (3.02%) compared to no interval FIT (0.47%) and interval FIT negative (0.17%) groups.
  • Patients with a positive interval FIT had an adjusted HR of 6.17 (95% CI 4.48 to 8.50) for PCCRC compared to those with no interval FIT.

Conclusions:

  • A positive interval FIT after colonoscopy is associated with a substantially increased risk of PCCRC.
  • Patients with a positive interval FIT should be offered prompt repeat colonoscopy for further evaluation and management.