| Theme | Clinical characteristics of fecal immunochemical test (FIT) negative colorectal cancer | |
|---|---|---|
| Title | Utility of and precautions with the use of the fecal immunochemical test for colorectal cancer screening | |
| Publish Date | 2019/09 | |
| Author | Masau Sekiguchi | Cancer Screening Center, National Cancer Center Hospital / Endoscopy Division, National Cancer Center Hospital / Division of Screening Technology, Center for Public Health Sciences, National Cancer Center |
| Author | Yutaka Saito | Endoscopy Division, National Cancer Center Hospital |
| Author | Takahisa Matsuda | Cancer Screening Center, National Cancer Center Hospital / Endoscopy Division, National Cancer Center Hospital / Division of Screening Technology, Center for Public Health Sciences, National Cancer Center |
| [ Summary ] | Fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening is performed across several countries, including Japan. For the population-based CRC screening in Japan, FIT is used as a primary screening tool and total colonoscopy is performed for individuals with positive FIT results. FIT has strengths of its noninvasiveness and good diagnostic ability for CRC. However, the screening sensitivity of FIT for CRC is not perfect, and, CRC may be missed with a single FIT. Thus, repeating FIT screening （annually in Japan） is essential, and the utility of FIT-based screening should be evaluated not by the performance of a single FIT but by that of the whole screening program, including repeated FIT screening. In this sense, FIT-based screening is an effective program when considered in totality. However, in order to increase the effectiveness of CRC screening, more aggressive use of total colonoscopy in the screening, including the use of total colonoscopy as a primary screening tool, is worth consideration. We need to discuss the optimal methodology to incorporate total colonoscopy into the FIT-based screening protocol to further reduce CRC mortality and incidence. | |