Implementation of Fecal Immunochemical Test-Based Program in Colorectal Cancer Screening

Investigators concluded that a prospective study on the implementation and outcomes of a fecal immunochemical test (FIT)-based screening program in conducted in Sao Paulo, Brazil, demonstrated the feasibility and efficacy of implementing FIT-based CRC screening in resource-constrained settings.

Published in Clinical Gastroenterology and Hepatology, the findings suggest a viable model for broader adoption throughout Brazil and potentially across Latin America, the authors concluded.

The study targeted asymptomatic individuals aged 50 to 75 years, a demographic at heightened risk for CRC. From a cohort of 9881 participants, 7.8% tested positive on FIT, prompting referral for subsequent colonoscopy. Impressively, 68.9% of those with positive FIT results complied with the colonoscopy recommendation, ensuring robust follow-up. The procedural quality was notably high, with a 99% adequacy rate for Boston scale and a 99.4% cecal intubation rate, underscoring the program's operational efficacy.

The findings revealed significant rates of neoplastic lesions among screened individuals, with CRC detected in 5.9% of cases. Adenomas, including advanced adenomas, were prevalent, emphasizing the program's capacity to identify precursor lesions crucial for early intervention. Age emerged as a significant factor associated with CRC prevalence, reinforcing the importance of age-targeted screening initiatives.

Crucially, higher FIT concentrations correlated with increased detection rates of CRC and advanced neoplasia, affirming FIT's utility as a sensitive screening tool, authors found. By overcoming logistical barriers and demonstrating high diagnostic yield, this approach holds promise for enhancing regional efforts in organized CRC screening, advancing public health initiatives aimed at reducing CRC mortality.

Reference
Sorbello MP, Ribeiro Júnior U, Eluf-Neto J, et al. Feasibility and colonoscopy yield using the fecal immunochemical test (FIT)-based colorectal cancer screening in a Latin American country. Clin Gastroenterol Hepatol. 2024;22(8):1719-1727.e1. doi:10.1016/j.cgh.2024.01.033