FIT is suitable for colorectal cancer screening with high sensitivity

Fecal occult blood test is a simple and feasible preliminary screening method for colorectal cancer.

The traditional guaiacal fecal occult blood test is affected by diet or drugs, and its sensitivity is low.

FIT is an immunoassay technology for detecting fecal hemoglobin levels in the body. It is highly sensitive, and it is recommended to perform FIT screening at least once a year if possible.

At present, FIT has basically replaced the traditional guaiacal occult blood test and become the main fecal occult blood detection technology in the screening of colorectal cancer in the population.

A recent meta-analysis of 19 studies showed that a FIT faecal hemoglobin threshold of 10 g/g was associated with 91% sensitivity and 90% specificity in the diagnosis of colorectal cancer. The sensitivity and specificity of FIT range from 6% to 56% and 68% to 99% for progressive adenomas with one or more of the following characteristics: length ≥10 mm, histological evidence of villous composition ≥25%, high-grade intraepithelial neoplasia.

Most domestic and international guidelines recommend that FIT screening be conducted once a year. Cost-effectiveness modeling studies have shown that annual FIT screening is comparable to the years of survival gained from a colonoscopy every 10 years.

Therefore, for those rejected by invasive colonoscopy, FIT can be selected for preliminary screening, and colonoscopy should be performed in time if FIT is positive.