AT A GLANCE

A new study published in Clinical Gastroenterology and Hepatology reports the outcomes of a two-sample fecal immunochemical test (FIT)-based screening program in China.¹

“[The] colorectal cancer (CRC) incidence and mortality of China account for nearly 30% of the global attributable fraction. We aimed to estimate the yield and effectiveness of a two-sample fecal immunochemical test (FIT)-based screening program in China,” explain study authors Xu et al.

According to the authors, among 246,349 individuals invited for two-sample FIT between 2007 and 2021, 150,524 (61.10%) participated, with 16,994 FIT+ cases (11.29%) (defined by a cutoff of 40 μg/g before 2013 or 20 μg/g thereafter) subsequently referred for colonoscopy. Of these, 12,816 (75.41%) participants ultimately underwent colonoscopy, yielding a detection rate and positive predictive value of 0.57% and 6.70% for advanced neoplasia, respectively.

Compared to those of FIT- participants, the CRC incidence and mortality rates were relatively similar among FIT+/colonoscopy compliers, with hazard ratios of 0.94 and 1.62, but higher among FIT+/colonoscopy non-compliers, with hazard ratios of 3.52 and 4.41. Separately, using the CRC incidence and mortality risk of FIT- participants at 50.0 years of age as the benchmark, FIT+/colonoscopy compliers were found to demonstrate the same risk at 50.6 and 46.1 years of age, while FIT+/colonoscopy non-compliers showed the same risk at 38.0 and 37.9 years of age, respectively.

“Two-sample FIT could effectively identify high-risk populations, and colonoscopy compliance is associated with a lower risk of CRC incidence and mortality. This strategy might facilitate CRC screening practice in countries with large populations,” conclude the authors.

Reference

1.     Xu Z, Yang J, He J, et al. Yield and effectiveness of 2-sample fecal immunochemical test-based screening program for colorectal cancer. Clin Gastroenterol Hepatol. 2025;23(7):1238–1246.e6.