Follow-up of Positive Fecal Test Results

Sooner Is Better, but How Much Better?

Published in: JAMA, 2017 Volume 317, Number 16 (April 2017), pages 1627-1628. doi:10.1001/jama.2017.3629

Posted on RAND.org on May 23, 2017

by Carolyn M. Rutter, John M. Inadomi

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A large body of research demonstrates that colorectal cancer screening is an effective method for reducing colorectal cancer mortality. Screening can detect cancer at an earlier stage, before it becomes symptomatic, and the detection and removal of adenomas can prevent cancer. Rates of colorectal cancer screening had increased until 2010, at which time approximately 60% of eligible US adults participated in colorectal cancer screening; however, screening has not increased since that time. Colonoscopy is the most commonly used colorectal cancer screening test, but it is an invasive procedure and can be both costly and inconvenient for patients. Many patients prefer less-invasive tests. Increased use of the fecal immunochemical test (FIT) has the potential to expand the use of colorectal cancer screening to a broader range of patients. However, the effectiveness of FIT depends on several layers of adherence including the initial screening test, repeated annual screening among those with negative test results, and follow-up colonoscopy among patients with positive test results.

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