Protected by the Test of Time: Fecal Immunochemical Test Reduces Risk of Colorectal Cancer Deaths

Despite years of medical advancements, colorectal cancer (CRC) continues to be a major cause of cancer fatalities globally. Screening is instrumental in early detection and prevention, and one widely used method is the fecal immunochemical test (FIT). A recent large-scale nested case-control study, led by Dr. Chyke A. Doubeni and a team of other experts, has provided community-based evidence that supports utilizing FIT to significantly lower the risk of CRC death, with noteworthy effects across various demographic groups.

The study, which spanned from January 2002 to December 2017, focused on a diverse screening-eligible population within two large integrated health systems. Researchers compared individuals who died from CRC (cases) between 2011 and 2017 to living, CRC-free individuals (controls), ensuring matching based on age, sex, and other factors. They aimed to understand the association between completing one or more FIT screenings and the subsequent risk of dying from CRC.

Among the 10,711 participants (drawn from an initial cohort of over 2 million), those who underwent FIT screening demonstrated a 33% overall reduction in CRC death risk. Remarkably, for cancers in the left colon and rectum, the risk was reduced by an impressive 42%. However, the association didn't hold for cancers located in the right colon. When looking at the data across racial and ethnic groups, FIT screening corresponded with lower CRC mortality risk among non-Hispanic Asian, non-Hispanic Black, and non-Hispanic White individuals.

This study's results bolster the argument for community-based organized CRC screening using FIT—a relatively simple test conducted at home without the need for an in-person visit. Given the observed advantages, including the potential narrowing of racial disparities noted by Doubeni and colleagues in earlier works, FIT screening could be a critical component in population health strategies to combat CRC mortality.

The findings are particularly compelling as they suggest the benefits of FIT screening are prevalent regardless of the location of the cancer within the colon, albeit with more pronounced effects on left-sided colon and rectum cancers. Moreover, the study's design considers various variables, like test indications and comorbidities, enhancing the reliability of the results.

As the study's information has been made open access, under the CC-BY License, it contributes significantly to our knowledge and supports an evidence-based populace-level approach to CRC screening. These conclusions serve as a testament to the test's effectiveness in the fight against CRC and underscore the importance of organized screening programs to realize the potential of FIT in saving lives.

For those interested in delving deeper into the research, the full article is available and distributed under the CC-BY License as stated by JAMA Network Open (JAMA Network Open. 2024;7(7):e2423671. doi:10.1001/jamanetworkopen.2024.23671).

This summarized research signifies an impactful step forward in CRC prevention, offering hope that FIT screenings might indeed contribute to fewer CRC deaths in susceptible populations. As always, for those intrigued by the intricacies of medical screening and the pursuit of cancer prevention, the complete article awaits.

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