3 studies from Digestive Disease Week that provide insights for FIT screening

At Digestive Disease Week 2016, several researchers presented on fecal immunochemical testing and how it is becoming the "go to" screening test for colorectal cancer, Gastroenterology and Endoscopy News reports.

Here's what you should know.

1. Esmée J. Grobbee, MD, of Erasmus MC University Medical Center, in Rotterdam, reported that multiple rounds of FIT detected more colorectal neoplasia per invited person than a one-time sigmoidoscopy or colonoscopy. Although the colonoscopy detected more advanced lesions.

The study featured 15,046 men and women between 50-years-old and 74-years-old for four rounds of FIT, 8,407 one-time sigmoidoscopies and 6,600 one-time colonoscopies. The final study population totaled 28,515.

More than two-thirds of people who underwent FIT completed multiple rounds, fewer than one-third completed the one-time endoscopy. Positivity tests for four rounds of FIT was around 20 percent, while sigmoidoscopy and colonoscopy were both under 10 percent.

Two rounds of FIT detected 41 percent more advanced neoplasia than a one time sigmoidoscopy. Four rounds had a 200 percent increase in detection compared to colonoscopies. Multiple rounds of FIT also detected more colorectal cancers than endoscopy.

However, the participants found advanced neoplasia was 35 percent lower with multiple FIT than it was for other the other procedures.

2. Dr. Grobbee also presented a study that showed fecal hemoglobin in negative FIT can predict the risk for future advanced adenomas. Fecal Hb level could be a means of "risk-stratifying patients and optimizing colorectal cancer screening.

In the study, 7,663 people with negative findings on fecale with a fecal Hb about 8 to 10 mcg Hb/g had their risk increased eightfold for developing a future adenoma within five years.

3. Douglas J. Robertson, MD, of White River Junction VA Medical Center, in Vermont, presented a study he helped with that looked at FIT versus colonoscopy screening in 50,000 veterans. Researchers were hoping to learn if the season of the year and the interval between collection and processing could affect the likelihood of having a positive test.

Participants randomly assigned to FIT submitted a sample annually by mailing it to a central laboratory for processing where samples were refrigerated until processing.

Hemoglobin results of at least 20 mcg HB/g of stool were considered positive. FIT kits received more than 14 days after collection were not positive.

Of the 22,957 FIT kits processed, 6.8 percent were positive. A collection date was not recorded on 20,141 kits and of those 6.7 percent were positive. Another 2,816 did not specify any data and 7.1 percent of those were positive.

Dr. Robertson defended the decision to process those without a data by saying there was no difference in the positivity rates whether the collection date was on it or not.

Positive rates were at 7.3 percent during the winter to 5.8 percent during the summer.

More news related to gastroenterology and endoscopy:
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Dr. Ellen Beswick receives $1.7M NIH grant to study colorectal cancer: 5 notes
5 most read GI/endoscopy stories: Aug. 22-Aug. 26

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