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Data presented reflect results to date of the study "The Value of IntervalFecal Occult Blood Testing in Colonoscopy-Based Surveillance Program (CSP) forPeople at Increased Risk for Colorectal Cancer" conducted at the FlindersCentre for Innovation in Cancer of South Australia, in which individuals witha family or personal history of colorectal cancer or adenoma were entered intoa CSP. In each intervening year between required colonoscopies, individualswere offered a FIT test to complete at home, using a brush sampling method tocollect water-based samples for laboratory analysis. Study groups included ascreening cohort (n=1736), broken down into a FIT cohort (n=1071) of patientswho returned at least one valid interval FIT test with subsequent colonoscopyand a non-FIT cohort (n=665), comprised of patients who did not complete a FITtest. Study-required colonoscopies were scheduled at either three or five yearintervals, according to the patient's medical situation.
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The interim report showed that, while the same number of colorectalcancers were discovered in the FIT cohort (n=14) and the non-FIT cohort(n=14), colorectal cancers in the FIT cohort were detected an average of 26.5months earlier than they would have been during a study-required colonoscopy.
Patients in the FIT cohort diagnosed with treatable Stage I (Dukes StageA) cancer (n=5), were diagnosed an average of 17.5 months earlier than theywould have been with a study-required colonoscopy alone, and those withtreatable Stage II (Dukes Stage B) cancer (n=2) were diagnosed an average of21.8 months earlier than they would have been with a study-requiredcolonoscopy alone. Detection of advanced adenomas in the FIT cohort (n=60;non-FIT n=54) occurred 18.4 months earlier than would have occurred during thestudy-required colonoscopy.
Overall, the interim report showed that interval FIT testing under thisstudy program detected 86 percent (12 of 14) of colorectal cancers and 63percent (60 of 96) of advanced adenomas greater than 10 mm.
Colorectal cancer is the second leading cause of cancer death in theUnited States(1), but when found early and treated, the five-year relativesurvival rate for colon cancer is 90 percent.(2) Currently, less than 40percent of colorectal cancers are found early.(3) The new data presentedtoday at DDW suggest that annual colorectal screening with FIT tests may helpincrease early detection.
"Our interim report indicates that undertaking annual FIT testing inhigh-risk groups -- between planned surveillance colonoscopies -- is valuablebecause it reduces delays in the diagnosis and treatment of colorectal cancerand advanced adenomas," said primary investigator Graeme P. Young, MD, FRACP,Professor of Gastroenterology and Academic Head of GI Services, Director,Flinders Centre for Innovation in Cancer of South Australia. "For the medicalcommunity dedicated to preventing and treating this major disease, we now haveevidence that annual screening of high-risk patients with a convenient,take-at-home test can catch not only colorectal cancer earlier but advancedadenomas as well, given the notable CSP study program sensitivity of 63percent."
American Cancer Society (ACS) guidelines recommend colonoscopy every fiveyears for patients with a family history of colorectal cancer and for patientswith a personal history of colorectal cancer who have had a normal 3-yearcolonoscopy, and mor
