what percentage of positive fit tests are cancer?

Fecal occult blood test: The fecal occult blood test (FOBT) is a lab test used to check stool samples for hidden (occult) blood. The fecal immunochemical test (FIT) is a screening test for colon cancer. Tumors were stratified by location. G, Huang We assessed the stability of our findings in a series of sensitivity analyses (eTable 1 in the Supplement). All Rights Reserved, Challenges in Clinical Electrocardiography, Clinical Implications of Basic Neuroscience, Health Care Economics, Insurance, Payment, Scientific Discovery and the Future of Medicine, 2017;177(8):1110-1118. doi:10.1001/jamainternmed.2017.2309. AL, It tests for non-visible blood in poo, which can be an early sign of bowel cancer. independently assessed risk of bias, inconsistency, indirectness, imprecision, and publication bias. C, et al. The test, known as the fecal immunochemical test (FIT), checks for traces of blood in patient-collected stool samples, which can be an early sign of cancer. To assess the diagnostic accuracy of FIT for CRC or advanced neoplasia (AN) in asymptomatic patients at above-average risk. The study should also evaluate the location and detection rate of advanced adenomas and quantitative fecal hemoglobin results during the rounds of testing. We assessed the full text of the remaining 202 reports. FIT only detects human blood from the lower intestines. et al. We converted units for FIT cutoff thresholds to micrograms of hemoglobin (Hb) per gram of feces.14 Two authors (A.K. JS, Piper One study we published showed that by increasing screening rates from 40% to 80%, we could cut the incidence of colorectal cancer deaths in half, he said. Cologuard is one of six approved methods for colon cancer screening in the United States, including one of three stool-based tests. We pooled results from 5 studies that were deemed at low risk of bias. In the study, Imperiale and his colleagues determined that when the FIT was set to be more sensitive, the test caught 95 percent of cancers, but resulted in 10 percent false positives. Both studies focused on a single screening episode analysis, which cannot account for the potential contribution of repeated FIT applications to overall screening effectiveness, they added. Study selection methods. Stool samples collected at home are sent in for analysis. EG, Bent Conclusions and Relevance It tests for hidden blood in the stool, which can be an early sign of cancer. I didn't follow that and put myself through agony for weeks. et al; EPICOLON Group. You can also reduce your risk of bowel cancer by: keeping physically active. Over that time, about 2 percent of the people, about 2,700 of them, had positive tests. Systematic Review Data Repository. Fecal immunochemical test accuracy in familial risk colorectal cancer screening. This points to one possible reason why people in this group, on average, were less likely to get follow-up colonoscopy exams, Dr. Corley said. E, AZ, Carillo-Palau EA, Jaeschke Dr. Corley, who is the lead investigator for the colon cancer component of PROSPR, stressed the effectiveness of colorectal cancer screening. FJ, Customize your JAMA Network experience by selecting one or more topics from the list below. What is the diagnostic accuracy of fecal immunochemical testing (FIT) for screening of colorectal cancer (CRC) or advanced neoplasia in asymptomatic high-risk populations? et al. Accuracy of fecal immunochemical tests for colorectal cancer: systematic review and meta-analysis. E, Nicols-Prez CR, Accessibility Statement, Our website uses cookies to enhance your experience. RM, Whiting Reasons for participation and nonparticipation in colorectal cancer screening: a randomized trial of colonoscopy and CT colonography. On subsequent colonoscopy, 40% of those with positive tests had either advanced adenomas or cancer. Based on GRADE summaries (eTable 2 in the Supplement) we deemed the quality of the evidence to be low or very low. Two authors (A.K. P, Leshno About 10-15 percent of people screened with FIT will have an abnormal result and will require additional testing. Our results suggest that given FIT safety, simplicity, low cost, and low discomfort, it could be used as an acceptable alternative for screening of individuals at increased risk for CRC. All studies assessed the accuracy of FIT for AN,26-37 but only 7 studies (4790 patients) reported data specifically for CRC.27,29,31-35 Prevalence of AN ranged between 3.2% and 14.5% and between 0.6% and 2.1% for CRC. Z, Birkenfeld by Elia Ben-Ari, December 22, 2022, The rate increased with age, but the rates found at all ages are much lower than rates of cancer in people undergoing screening colonoscopy without a prior FIT, lead authors George F. Longstreth, MD, and Daniel S. Anderson, MD, FACP, of Kaiser Permanente, Southern California, San Diego, told CLN Stat in a statement. Continuing without changing cookie settings assumes you consent to our use of cookies on this device. and P.P.) (DNA tests, however, do return more . et al; US Preventive Services Task Force. The positivity rate was 8.4%. The primary outcome was the diagnostic performance of FIT for detecting CRC or AN. 2 It is used to detect colon cancer, also known as colorectal cancer, which is the third most common cause of cancer deaths in the United States. FIT only detects human blood from the lower intestines. In our main analysis, FIT sensitivity and specificity for diagnosing CRC ranged from 0.25 to 1.00 (median, 0.81) and from 0.87 to 0.95 (median, 0.91), respectively. JB, Linnet Inc32,37; OC-light, Eiken Chemical28; and HemeSelect, Smith-Kline Diagnostics30). . The first stool tests developed were based on the finding of occult, or hidden, blood. Jiang Data have been presented for the as-screened population, because . The low incidence of colorectal cancer after that was likely due to the early detection of cancers and the removal of precancerous lesions during colonoscopy, Dr. Breslau explained. We synthesized data regardless of the FIT cutoff used. Mine were hemorrhoids. Mean age ranged from 46.0 to 63.2 years, and percentage of males ranged from 30.2 to 50.6%. How often does cologuard give a false negative? 900 Seventh Street, NW Suite 400 To fully evaluate FIT sensitivity and effectiveness, a longitudinal study should assess its performance over several rounds of testing, taking into account the stage and site distribution of screen-detected CRCs and [interval CRCs] ICs in each round, they suggested. It is a very sensitive test, and that polyps, hemorrhoids (both internal and external), and ulcers can all cause a positive fit test. Fecal immunochemical test (FIT). US Department of Health & Human Services Agency for Healthcare Research and Quality. Both studies appear in the Clinical Gastroenterology and Hepatology journal. Positive and negative predictive values were 43.8% and 94.0%, respectively. This important new program offers colorectal cancer screening to asymptomatic men and women between the ages of 50 and 74. AACC.org Male sex (OR = 1.30, 95%CI 1.03, 1.62), age 65 years (OR = 1.27, 95%CI 1.01, . Bossuyt The main advantage of this test, which costs . Terms of Use| Are fit tests accurate? Fortunately, with routine screening . About 60% of the time, they'll find nothing; about 35%, a polyp; about 4%, a very early cancer; about 1% a less early cancer. moderator 3rd September 2020. Nevertheless, all included studies evaluated 1-time application of the test, and results could not be transferred to repeat screening programs. Of the 432 participants who had a positive fecal immunochemical test, 285 underwent a colonoscopy (235 participants showed no polyps or cancer, 47 had polyps identified, and three had colorectal cancer identified). CA. It may not seem like 7 years is a huge difference, but the colorectal cancer prevalence from the under 45 age bracket is much lower than 50+. In this systematic review and meta-analysis, we found reasonable diagnostic accuracy of FIT for CRC (AUC, 0.93) and AN (AUC, 0.86) in individuals with either a personal or family history of CRC. at the National Institutes of Health, An official website of the United States government, Colonoscopy after Positive FIT Test Cuts Risk of Colorectal Cancer Death, has been shown to reduce deaths from this disease, were twice as likely to die as those who did have a follow-up colonoscopy, peoples fears about the preparation for colonoscopy, cut the incidence of colorectal cancer deaths in half, Drug Targets Common Mutation in Pancreatic Cancer. But because you use FIT every year, 10 . Brozek Can patients at high risk for significant colorectal neoplasms and having normal quantitative faecal occult blood test postpone elective colonoscopy? Hierarchical summary receiver operating curve (HSROC) plot of sensitivity versus specificity for performance of FIT in studies using quantitative FIT with cut off value less than 25g/g only in patients with familial risk of CRC, eTable 1. CG, Allison Author Contributions: Dr Tsapas had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Statistical analysis: Katsoula, Paschos, Haidich, Tsapas. After deduplication, 2154 titles and abstracts were screened and 1952 records were rejected or deemed ineligible. Findings come from a study that is part of a larger effort to address screening disparities. However, the robustness of our results was verified in a series of subgroup analyses. Such a strategy is associated with higher cost, lower adherence, and higher risk for rare, but serious, complications.2-6. Terhaar sive Droste 2023 American Medical Association. The Journal of Applied Laboratory Medicine, A Global Strategy to Eliminate Cervical Cancer, A New Model for Personalized Reference Intervals, How Fit Is FIT for Detecting Colorectal Cancer, How Underspecification Undermines Artificial Intelligence, The Sprint Toward a Better SARS CoV 2 Diagnostics Data System, Commission on Accreditation in Clinical Chemistry. As tests evolve and costs of cancer care rise: reappraising stool-based screening for colorectal neoplasia. The observed trend toward a reduction of the protective effect of FIT screening with increasing interval since the last negative test also is consistent with previous findings. Good luck to you, and take care. A. FN indicates false-negative results; FP, false-positive results; TN, true-negative results; TP, true-positive results. Medicines and foods do not interfere with the test. Levi World Health Organization International Agency for Research on Cancer. In a pragmatic trial34 assessing the effectiveness of a diagnostic strategy using annual FIT for 3 years for detection of AN vs colonoscopy in asymptomatic patients with a family history of CRC, annual FIT was as good as colonoscopy for AN; however, it missed almost 40% of advanced adenomas. MC, Ching // FIT is the dominant screening test for colorectal cancer in most economically advanced countries, and the results support the accuracy of widespread periodic FIT screening, they added. Colorectal Cancer: Estimated Incidence, Mortality and Prevalence Worldwide in 2012. We included 12 studies (6204 participants). CM, Gatsonis During the period 2000-2017, the accumulated risk of a 'false positive' result was 16.2% adjusted for age, sex and type of test. The ongoing NCI-funded PROSPR program aims to better understand how to improve the cancer screening process and reduce disparities in colorectal and other cancer screening in community health care settings in the United States. Conclusions and Relevance Among patients with a positive fecal immunochemical test result, compared with follow-up colonoscopy at 8 to 30 days, follow-up after 10 months was associated with a higher risk of colorectal cancer and more advanced-stage disease at the time of diagnosis. These data therefore are providing additional evidence supporting the adoption of a 2-year interval for FIT screening, wrote Senore and Zorzi. and P.P.) AF, Laheij However, FIT positivity rates and positive predictive value (PPV) can vary substantially, with false-positive (FP) results adding to colonoscopy burden without improving cancer detection. Diagnostic Accuracy of Fecal Immunochemical Test in Patients at Increased Risk for Colorectal Cancer: A Meta-analysis. What Causes Immunotherapys Heart-Related Side Effects? Applying Grading of Recommendations Assessment, Development and Evaluation (GRADE) to diagnostic tests was challenging but doable. R, Broek Chubak et al reported that the return rate of any stool blood test after kit mailing within 6 months was 69% versus 64% (P < .005) for 1-sample versus 2-sample testing, respectively, 11 whereas Mosen et al reported that the kit return rate within 6 months was 43.4% versus 39.6% (P = .012), respectively. This study emphasizes that cancer screening is really a process, not a single step, and shows the importance of completing all steps of the process, said gastroenterologist Douglas Corley, M.D., Ph.D., of Kaiser Permanente, Northern California, who was not involved in the study. It is a noninvasive, private way to check for colon cancer without having to leave your house. Quiz Ref IDColonoscopy is currently the only recommended screening modality for participants at increased risk of CRC owing to personal or family history.3 However, no study has documented the effectiveness of this policy on CRC incidence or mortality. It is really a good thing that you are fast tracked for a colonoscopy, as it will be the only way to know what's going on. S, Levin Administrative, technical, or material support: Katsoula, Paschos, Tsapas, Giouleme. Forest plots demonstrated a high degree of heterogeneity for sensitivity estimates (Figure 2). Purpose of a Cologuard Test. The trials reported a low positive predictive value (PPV) for the FOBT test, suggesting that most positive tests were false positives. The new faecal immunochemical test (FIT) is due to be introduced into the bowel cancer screening programme (BCSP) in England later this year to replace the current test. For the study, Manuel Zorzi, M.D., M.Sc., of the Veneto Tumour Registry in Padua, Italy, and his colleagues, examined the medical records of participants in a regional colorectal screening program who took a FIT test between January 1, 2004, and September 30, 2017. According to a 2014 clinical study, about 13% of results from Cologuard were false positives and 8% were false negatives. Screening for colorectal cancer, the second leading cause of cancer-related deaths in the United States and other high-income countries, has been shown to reduce deaths from this disease. Finally, we graded the quality of the body of evidence using appropriate methodology (GRADE). Hierarchical models were used to synthesize available evidence. SC, M, Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening. A, FIT is currently FDA-approved for spontaneous stool and DRE, however, samples are not commonly obtained by DRE. Bowel cancer (colorectal cancer, CRC) is the second most common cause of cancer death in the UK, accounting for 10% of all cancer deaths in 2017. Quantitative and 1-sample FIT showed adequate test performance, but data on other FIT brands and multiple samples were insufficient. The test looks for tiny traces of blood in the stool, a way of screening people for colon cancer. Source: CLN Stat. et al; GRADE Working Group. Tests and investigations for colorectal cancer screening. et al; COLONPREV Study Investigators. A hierarchical regression approach to meta-analysis of diagnostic test accuracy evaluations. Stool tests are done to look for signs of cancer by testing for blood in . Finally, we could not calculate the pooled estimates in a sensitivity analysis including only studies at low risk of bias in patients with family history of CRC that used immediate colonoscopy due to limited data. The FIT has high overall diagnostic accuracy for CRC but moderate accuracy for AN in patients at above-average personal or familial risk. AZ, Quintero Respective estimates for AN were sensitivity, 47% (95% CI, 39%-55%); specificity, 94% (95% CI, 91%-96%); LR+, 8.10 (95% CI, 5.90-11.20); and LR, 0.56 (95% CI, 0.49-0.65) (eFigure 6 in the Supplement). A quantitative immunochemical fecal occult blood test for colorectal neoplasia. Results were at least as good as from previous systematic reviews focusing n average-risk individuals.10,11,38 To ensure internal validity of our conclusions, we implemented current guidelines for the conduct and reporting of systematic reviews12,39 and used a prespecified protocol. by Sharon Reynolds, National Cancer Institute The greatest concern regarding applicability was due to the FIT and the reference standard used. Seven studies were deemed at high or unclear risk of bias. A single FIT test detects about 73 percent of colorectal cancers. This means that when the test came out positive, there actually was an abnormality 90 percent of the time with Cologuard and 95 percent of the time with FIT. Meaning what percentage of positive fit tests are cancer? . Given the safety, simplicity, low cost, and minimal discomfort of FIT, it is a viable alternative screening strategy for patients at increased risk for CRC. Synopsis of results from sensitivity analyses depending on risk of bias, patient population and reference standard used for the diagnosis of colorectal cancer and advanced neoplasia, eTable 2. Despite the use of an exhaustive and meticulous search strategy, we could only find 12 eligible studies. Eight studies used 1-sample FIT,26,28,30,32-34,36,37 2 studies used 2-sample FIT,27,35 and 2 studies used 3-sample FIT.29,31, All studies used colonoscopy as a reference standard. Privacy Policy| Levi Quintero DA. M, Parra-Blanco Fecal DNA testing was 92% sensitive and 87% specific, whereas FIT was 74% sensitive and 95% specific. Further research is needed to assess whether this relationship . JK, Liles Two authors (A.K. Six studies were deemed at high risk of bias,26,28,30,32,34,37 1 study at unclear risk,36 and 5 studies at low risk of bias.27,29,31,33,35, All but 1 study reported use of consecutive or random sampling.30 FIT was used prior to the reference standard in 11 studies, and only 1 study did not provide relevant data.36 All studies used prespecified FIT thresholds. The study points to the importance of more closely monitoring people who do not follow recommendations after a positive FIT result, said Erica Breslau, Ph.D., M.P.H., of NCIs Healthcare Delivery Research Program, who also was not involved in the study. PM, Zwinderman Colonoscopy is an invasive, expensive procedure with an established risk of complications.40,41 Population-based studies and randomized trials suggest that adherence to use of colonoscopy for screening in average and increased-risk populations is usually suboptimal.42 This undermines the efficacy of screening programs43 and underlines the need for alternative screening modalities that may limit the need for colonoscopy only to those participants with positive results. Beyond diagnostic accuracy: the clinical utility of diagnostic tests. ST, Oort and percentage of males ranged from 30.2 to 50.6%. M, However, most studies had a small sample size or low prevalence of CRC or AN, limiting the precision of effect estimates. As the broader DG30 criteria create a potentially enormous pool of low-risk patients, triage with FIT may lead to an overall increase in patients with false-positive . . Can Cologuard detect cancer? PS, Bostock Many colorectal cancer screening programs, including some in the United States, struggle to ensure timely colonoscopy completion among those with a positive FIT, with rates as low as 50%, Dr. Zorzi and his colleagues wrote. A positive FIT is not a colorectal cancer diagnosis, but we do know that it can cause a great deal of anxiety. For example, peoples fears about the preparation for colonoscopy continue to be a major barrier. If FIT testing is utilized as a CRC screening method, single-vial FIT screening is recommended by Polymedco, the National Cancer Institute, and the VHA. Data extraction and quality assessment were conducted in duplicate. Data Extraction and Synthesis Several limitations have to be acknowledged about the evidence and the review itself. We also searched trial registries and abstracts from relevant scientific meetings, as well as scanned websites of companies manufacturing FITs. A, Jimnez-Sosa Stool DNA testing. The pooled sensitivity and specificity for AN were 48% (95% CI, 39%-57%) and 93% (95% CI, 91%-94%), yielding an LR+ of 6.5 (95% CI, 5.0-8.5) and an LR of 0.57 (95% CI, 0.48-0.67). Repeat use of FIT and higher compliance to screening schedules48 could potentially counterbalance the superior accuracy of colonoscopy in the diagnosis of AN. The Bayesian estimate from the positive test result is almost seven times the assumed 0.7% prevalence. The FIT identified patients with CRC with overall high sensitivity but missed nearly 50% of small (T1) and 32% of UICC stage I CRCs. JAMA Intern Med. The last search was performed in August 2016 (eFigure 1 in the Supplement). JL, Akl Another study examined the merits of colonoscopy in patients with negative FIT tests in a large program that conducted annual screening. M, Gimeno-Garcia May 5, 2022 , by Elia Ben-Ari. We included studies that reported the diagnostic accuracy of FIT for CRC or advanced neoplasia (CRC, or adenomas 10 mm or with 25% villous component and/or high-grade dysplasia) in asymptomatic adults with family history of CRC or personal history of CRC or advanced adenomas and used colonoscopy or follow-up as the reference standard. L, Any disagreement was resolved through discussion or by consulting a third author (A.T.). Quiz Ref IDUse of cutoff values between 15 to 25 g Hb/g feces had the best combination of sensitivity and specificity for the diagnosis of CRC (93% and 94%, respectively), as well as the highest LR+ (15.1) and lowest LR (0.07). D, Liberati M, Hernndez-Guerra Washington, DC 20001 In this cohort, the overall rate of cancer was 1.4 per 1,000. This delayed diagnosis likely explains the higher death rate from colorectal cancer in this group, Dr. Breslau said. Brozek 2023 American Medical Association. According to editorialists Senore and Zorzi, the study sheds new light on the tests sensitivity with respect to tumor characteristics. The program offers free FIT testing once every 2 years to people 5069 years old. GP; Expert Working Group on Fecal Immunochemical Tests for Hemoglobin, Colorectal Cancer Screening Committee, World Endoscopy Organization. Amersi Two authors (A.K. The test isn't always accurate. While this is a relatively small percentage, it is important to note that a positive fit test result can be an indicator of cancer and should be taken seriously. Specifically, the investigators wanted to see if a colonoscopy identified any cancer missed by the FIT. KG. Findings from the study, which was conducted in Italy, were published March 31 in Gut. // In 3 relevant studies, sensitivity for CRC varied from 67% to 100% and specificity from 83% to 95%. For studies using multiple-sample FIT, positivity was rated based on the highest amount of fecal Hb measured in patient samples. We assessed quality using a meticulous, recently developed tool (QUADAS-2). et al. VC, Sensitivity 98%; . DC, Curry 1 In order to reduce mortality and incidence of CRC, the National Health Service Bowel Cancer Screening Programme (NHS BCSP) in . Fairly inexpensive. The full text of the remaining 202 reports were assessed, and 12 studies met the inclusion criteria and were included in the systematic review.26-37 DARE indicates Database of Abstracts of Reviews of Effects. FIT has high overall diagnostic accuracy for CRC in increased-risk individuals. Medicines and food do not interfere with the test. Low sensitivity of FIT for early-stage CRC underlines the need for research on potential improvements in FIT-based CRC screening. You can change these settings at any time, but that may impair functionality on our websites. Synopsis of Results From Subgroup Analyses Depending on Cutoff Value, Type of FIT and Number of FIT Samples Used for the Diagnosis of Colorectal Cancer or Advanced Neoplasia. 20 participants of the 47 who had polyps had advanced adenomas . Colonoscopy is currently the only recommended screening modality for participants at increased risk of CRC owing to personal or family history. The average sensitivity of FIT for AN was 48% (95% CI, 39%-57%); and the average specificity was 93% (95% CI, 91%-94%), yielding an LR+ of 6.55 (95% CI, 5.0-8.5) and an LR of 0.57 (95% CI, 0.48-0.67) (GRADE: very low). TR, de Haan Lin RJ, Quiz Ref IDDespite the use of an exhaustive and meticulous search strategy, we could only find 12 eligible studies. Finally, we evaluated the clinical utility of FIT utilizing Fagan nomograms to depict posttest probability in patients at increased risk for CRC and AN. JB, Glas So it tends to be more accurate and have fewer false positive results than other tests. Pooled test characteristic estimates for diagnosing CRC were sensitivity, 97% (95% CI, 62%-100%); specificity, 91% (95% CI, 89%-93%); LR+, 11.20 (95% CI, 8.30-15.10); and LR, 0.03 (95% CI, 0.00-0.60). DA, McFarland independently extracted data from each included study, using Systematic Review Data Repository.13 For studies presenting results for multiple FIT thresholds, we extracted all data to maximize the yield of information. What is a FIT? Grading quality of evidence and strength of recommendations in clinical practice guidelines: part 1 of 3. an overview of the GRADE approach and grading quality of evidence about interventions. A proposal to standardize reporting units for fecal immunochemical tests for hemoglobin. This is especially important for those who are averse to colonoscopy. Free phone consultations with a registered nurse is available for people who test positive for a medical condition using one of LetsGetChecked tests. and P.P.) In our main analysis, for studies presenting results at multiple FIT thresholds, we used data for the lowest cutoff and the minimum number of samples available. By continuing to use our site, or clicking "Continue," you are agreeing to our, Figure 2. Subgroup analyses for quantitative FIT and 1-sample FIT showed consistent findings supporting their accuracy; however, we could not draw any conclusions about the diagnostic accuracy of qualitative FIT or use of multiple samples due to insufficient evidence. Of those, about 1.2% have a positive fit test result. NCCN Guidelines For Colorectal Cancer Screening (Version 2.2016). On the other hand, our results also show that FIT could diagnose only half of the cases with AN. AW, Scholten Eleven studies were cross-sectional and 1 was a randomized clinical trial.34 Two studies were reported only in abstract form.26,36 Nine studies included only first-degree relatives of CRC patients.26-28,30,32-34,36,37 Three studies included individuals either with a family history of CRC or prior history of CRC or advanced adenomas.29,31,35 Of these, only 2 studies reported results for subgroups.31,35, Eight studies evaluated quantitative FIT (OC-sensor/OC-micro, Eiken Chemical),26,27,29,31,33-36 while 4 studies used qualitative FITs (Hemosure, W.H.P.M. This meta-analysis assesses the diagnostic accuracy of fecal immunochemical tests for colorectal cancer or advanced neoplasia in asymptomatic patients with an a . People with a positive FIT test result are advised to have a colonoscopy to investigate the cause of the bleeding because a FIT test alone cannot diagnose cancer. // Surveillance after polypectomy and after resection of colorectal cancer. So, in 10 percent of cases using . 95 percent CI 5.1-9.3 percent predicts FIT will be positive in this low-risk symptomatic group, whereas 99.8 per cent CI 99.5-99.9 per cent predicts FIT would be negative. the bowel cancer screening test detects most (up to 85%) but not all bowel cancers; This is why it's important to do the screening test every 2 years between 50 and 74. Thus, our results suggest that in increased-risk individuals FIT has high diagnostic accuracy for CRC. P, Hazazi However, those who did not get a follow-up colonoscopy were about twice as likely to die of colorectal cancer over a 10-year period as those who did have a follow-up colonoscopy. Colon cancer screening is appropriate for: Adults 45 and older with an average risk for colon cancer.

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