{"id":6678,"date":"2019-10-14T19:53:43","date_gmt":"2019-10-14T17:53:43","guid":{"rendered":"https:\/\/www.endoscopy-campus.com\/?post_type=ec-news&p=6678"},"modified":"2019-10-14T19:53:44","modified_gmt":"2019-10-14T17:53:44","slug":"one-positive-fit-and-one-negative-still-do-colonoscopy","status":"publish","type":"ec-news","link":"https:\/\/www.endoscopy-campus.com\/en\/ec-news\/one-positive-fit-and-one-negative-still-do-colonoscopy\/","title":{"rendered":"One Positive FIT and One Negative? Still Do Colonoscopy"},"content":{"rendered":"\n
Most fecal immunochemical testing as a screen for colon cancer is done with one sample. However, patients with a positive test sometimes request a second test, with the hope it will be negative. <\/p>\n\n\n\n
In a Dutch study, there were 21,078 subjects who completed two different fecal immunochemical tests (FITs), both with a positivity cutoff of 15 \u00b5g hemoglobin per gram feces. Both FITs were negative in 90% of participants, both positive in 5.5% of participants, and there were discordant results (one positive and one negative FIT) in 4.2% of participants. Patients with 2 positive FITs had higher mean fecal hemoglobin levels and substantial rates of advanced neoplasia (43%) and cancer (7.2%). In patients with discordant results, the rate of advanced neoplasia was still substantial at 21%, and 1.2% had cancer.<\/p>\n\n\n\n
<\/div>\n\n\n\n
Comment: This study shows that patients with a positive FIT should be sent to colonoscopy, and if the test is repeated and found to be negative, there is still a substantial yield of advanced neoplasia and cancer. Positive FITs should not be repeated in the hope of avoiding colonoscopy. <\/p><\/blockquote><\/figure>\n\n\n\n
<\/div>\n\n\n\n
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. <\/p>\n\n\n\n
<\/div>\n\n\n\n
<\/figure>
\n
\n\nDouglas K. Rex, MD, FASGE\n\n<\/p>\n<\/div><\/div>\n\n\n\n
<\/figure>
\n