| [ Summary ] |
The fecal immunochemical test (FIT) is shown to be effective in reducing the mortality rate in patients with colorectal cancer. FITs using a 2-day sampling method were introduced for colorectal cancer screening in Japan in 1992. If fecal occult blood testing shows positive results even on a single day, total colonoscopic examination is required, regardless of the quantity of occult blood. However, based on the Report on Regional Public Health Services and Health Promotion Services 2016, the rate of a complete examination was as low as 68.5 %, and the Comprehensive Survey of Living Conditions also showed that the screening rate in individuals aged 40-69 years was only 41.4 %. The rate of requiring total colonoscopic examination was 7.6 % in 2016, and the commonly used cut-off value was 20-30μg/g. Increasing cut-off values should be considered to reduce false-positive results. Improvement in the rate of complete examination requires immediate attention, and computed tomography colonography is expected to be useful in this regard. Despite its drawbacks in detecting right-sided colon cancer, health care practitioners need to reaffirm that FIT serves as the optimal screening test for colorectal cancer. It is necessary to create greater awareness among the general population regarding the utility of this test. |