Negative Colonoscopy for FIT-Positive Patients: Should We Keep Doing FIT?
Douglas K. Rex, MD, MASGE, reviewing Peng SM, et al. Gut 2020 Sep 28.
In this study from Taiwan, patients with a negative colonoscopy after a positive fecal immunochemical test (FIT) during the interval 2004 through 2009 were followed until the end of 2014. Some patients received subsequent FIT after colonoscopy and some did not. The incidence of colorectal cancer was 1.34 per 1000 person-years of observation in those who received subsequent FIT and 2.69 in those who did not. Higher fecal hemoglobin concentration was associated with increased risk. Compared to the group with fecal hemoglobin of 20 to 39, the risk of incident cancer was 1.93 for fecal hemoglobin of 40 to 59, 2.26 for fecal hemoglobin of 100 to 149, and 2.44 for fecal hemoglobin of 150 or higher.
A low adenoma detection rate (ADR) predicted interval cancer risk in univariate analyses but not multivariate analysis.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
Peng SM, Hsu WF, Wang YW, et al. Faecal immunochemical test after negative colonoscopy may reduce the risk of incident colorectal cancer in a population-based screening programme. Gut 2020 Sep 28. (Epub ahead of print) (http://doi.org/10.1136/gutjnl-2020-320761)