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 Researchers found the fecal immunochemical test
(FIT) is able to detect 79 percent of colorectal cancers without
making people change their diets or stop taking their medications,
as some other screening tests require.
"It's more user-friendly for the patient," Dr. Jeffrey Lee told
Reuters Health.
Lee, from the University of California, San Francisco and Kaiser
Permanente Northern California Division of Research, led the
analysis.
Colon cancer is the second leading cause of cancer-related deaths in
the U.S., according to the Centers for Disease Control and
Prevention (CDC). About 132,000 people were diagnosed with the
disease in 2010 and about 52,000 died from it.
The government-backed U.S. Preventive Services Task Force (USPSTF)
recommends people between ages 50 and 75 get screened by colonoscopy
every 10 years.
During a colonoscopy, a doctor uses a long flexible tube equipped
with a tiny video camera to see the interior of the colon.
Alternatively, the USPSTF says people in that age group can have a
high-sensitivity fecal occult blood test every year, or a
sigmoidoscopy — which is similar to a colonoscopy — every five years
in addition to fecal occult blood testing every three years.
Fecal occult blood testing (FOBT) is more cumbersome than FIT, Lee
said. It requires more samples and more pre-test changes to a
person's diet and medication schedule.
According to the USPSTF's website, the panel is currently planning
to analyze the effectiveness of FIT.
For the new study, published in the Annals of Internal Medicine, the
researchers searched databases of medical research for studies from
1996 through 2013 that looked at the effectiveness of FIT.
They included 19 studies in their final analysis. The studies each
included between about 100 and 28,000 people with no symptoms of
colon cancer.
In most cases, the participants used FIT and then were screened with
a colonoscopy soon afterward.
The researchers found FIT detected 79 percent of colon cancers after
one test. Among people who didn't have colon cancer, 94 percent
tested negative.
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For comparison, FOBT has a reported accuracy between 13 and 50
percent, according to the researchers.
While FOBT costs about $5 per test, the average cost of FIT is
about $22, according to the patient advocacy organization Colon
Cancer Alliance, Inc.
"Our study kind of confirms that FIT is an accurate test, but
ultimately my take-home message is that there are so many options
for screening," Lee said.
Janet Byron, a spokesperson for the Kaiser Permanente Division of
Research, told Reuters Health in an email that Kaiser Permanente
Northern California implemented systemwide FIT testing for adults
between 50 and 75 years old. The kits are distributed by mail, at
doctors' offices and in labs.
The healthcare system has a cancer screening rate of about 80
percent. That compares to the approximately 70 percent of people in
that age range who are screened nationally, according to the CDC.
Assuming people use it, FIT could lead to a greater reduction in
colon cancer deaths above what FOBT has already done, according to
Lee.
"I just recommend that for the general population to get screened,"
he said. "The best test is the one that actually gets done."
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Source: http://bit.ly/SQRXAa
Annals of Internal Medicine, online Feb. 3, 2014.
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