The Significance of Fecal Immunochemical Test to Screen for Colorectal Cancer in National Cancer Screening Program.
- Author:
Jun Uk LIM
1
;
Na Young BAE
;
Won Koung SONG
;
Jae Myung CHA
;
Joung Il LEE
Author Information
- Publication Type:Original Article
- Keywords: Colorectal Cancer; Fecal Immunochemical Test; Screening; National Colorectal Cancer Screening Programme
- MeSH: Adenoma; Aged; Barium; Cause of Death; Colonoscopy; Colorectal Neoplasms; Early Detection of Cancer; Enema; Humans; Male; Mass Screening; Medical Records; Occult Blood; Public Health; Retrospective Studies; Surveys and Questionnaires
- From:Intestinal Research 2010;8(2):126-134
- CountryRepublic of Korea
- Language:Korean
- Abstract: BACKGROUND/AIMS: Colorectal cancer (CRC) is one of the major causes of death and poses a major public health concern. The National CRC Screening Programme (NCSP) provides annual CRC screening using a fecal occult blood test for individuals >50 years of age since 2004. The purpose of the current study was to determine the outcomes and efficacy of a fecal immunochemical test (FIT) based on the NCSP in a quality-controlled university hospital setting. METHODS: We retrospectively reviewed the medical records and a standardized questionnaire from the NCSP of 3,852 individuals who underwent a FIT between March and December 2009. All of the subjects submitted a stool specimen for a FIT, while a double-contrast barium enema or colonoscopy was performed as a confirmatory examination for FIT-positive individuals. The CRC screening rate and rate of detection colorectal adenomas, advanced adenomas, and colorectal cancers by FIT were evaluated. RESULTS: The CRC screening rate with FIT was very high (72.3%), but the positive rate of detection by FIT was only 1.3%. The rate of detection for colorectal cancers, adenomas, and advanced adenomas by FIT was 0.08%, 0.39%, and 0.13%, respectively. The quantitative values of FIT in individuals with colorectal adenomas and cancers were significantly higher than other colorectal diseases. Men (P=0.001) and elderly individuals (P=0.039) were significantly more common in the FIT-positive group than the FIT-negative group. Approximately 28% of the subjects with FIT-positive tests did not receive a confirmatory examination. CONCLUSIONS: Although the FIT had a low rate of detection, the FIT was a useful screening tool for detection of CRC in the NCSP. It will be important to increase CRC screening rates and confirmatory examination rates.
