Abstract

Aim. The aim of this study is to evaluate the usefulness of the fecal immunochemical
test (FIT) in colorectal cancer screening, detection of precancerous lesions and early
colorectal cancer.
Material and methods. The study evaluated asymptomatic patients with
average risk (no personal or family antecedents of polyps or colorectal cancer), aged
between 50 and 74 years. The presence of the occult haemorrhage was tested with the
immunochemical faecal test Hem Check 1 (Veda Lab, France). The subjects were not
requested to have any dietary or drug restrictions. Colonoscopy was recommended in
all subjects that tested positive.
Results. In our study, we had a total of 1389 participants who met the inclusion
criteria, with a mean age of 61.2 ± 12.8 years, 565 (40.7%) men and 824 (59.3%)
women. FIT was positive in 87 individuals (6.3%). In 57/87 subjects (65.5%) with
positive FIT, colonoscopy was performed, while the rest of the subjects refused or
delayed the investigation. A number of 5 (8.8%) patients were not able to have a
complete colonoscopy, due to neoplastic stenosis. The colonoscopies revealed in 10
cases (0.7%) cancer, in 29 cases (2.1%) advanced adenomas and in 15 cases (1.1%)
non advanced adenomas from the total participants in the study. The colonoscopies
performed revealed a greater percentage of advanced adenomas in the left colon
compared to the right colon, 74.1% vs. 28.6% (p<0.001).
Conclusions. In our study, FIT had a positivity rate of 6.3%. The detection rate
for advanced neoplasia was 2.8% (0.7% for cancer, 2.1% for advanced adenomas) in
our study group. Adherence to colonoscopy for FIT-positive subjects was 65.5%.

Keywords

screening, colorectal cancer, faecal immunochemical test, advanced adenoma, occult bleeding