In Screening for Colorectal Cancer, Is the FIT Right for the Right Side of the Colon?
Authors: Chyke A. Doubeni, Theodore R. Levin
Journal: Annals of Internal Medicine (2018)

Editorials6 November 2018In Screening for Colorectal Cancer, Is the FIT Right for the Right Side of the Colon?Chyke A. Doubeni, MD, MPH and Theodore R. Levin, MDChyke A. Doubeni, MD, MPHUniversity of Pennsylvania, Philadelphia, Pennsylvania (C.A.D.) and Theodore R. Levin, MDKaiser Permanente Medical Center, Walnut Creek, California (T.R.L.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2444 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Colorectal cancer (CRC) is a leading cause of cancer mortality, with an estimated 881 000 deaths worldwide in 2018 (1). Colorectal cancer mortality rates have been decreasing in many industrialized countries in recent decades, driven—at least in part—by increased screening (2), underscoring the importance of expanding the reach of screening in communities. However, gaps in the evidence regarding currently available strategies still present a challenge when deciding how to optimize the detection of clinically important lesions throughout the colon. The fecal immunochemical test (FIT) is one of the most commonly used CRC screening methods worldwide; it is moderately sensitive, noninvasive, and ...References1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018. [PMID: 30207593] doi:10.3322/caac.21492 CrossrefMedlineGoogle Scholar2. Meester RG, Doubeni CA, Lansdorp-Vogelaar I, Goede SL, Levin TR, Quinn VP, et al. Colorectal cancer deaths attributable to nonuse of screening in the United States. Ann Epidemiol. 2015;25:208-213. [PMID: 25721748] doi:10.1016/j.annepidem.2014.11.011 CrossrefMedlineGoogle Scholar3. Morikawa T, Kato J, Yamaji Y, Wada R, Mitsushima T, Shiratori Y. A comparison of the immunochemical fecal occult blood test and total colonoscopy in the asymptomatic population. Gastroenterology. 2005;129:422-8. [PMID: 16083699] CrossrefMedlineGoogle Scholar4. Zorzi M, Hassan C, Capodaglio G, Narne E, Turrin A, Baracco M, et al. Divergent long-term detection rates of proximal and distal advanced neoplasia in fecal immunochemical test screening programs. A retrospective cohort study. Ann Intern Med. 2018;169:602-9. doi:10.7326/M18-0855 LinkGoogle Scholar5. Delgado-Rodríguez M, Llorca J. Bias. J Epidemiol Community Health. 2004;58:635-41. [PMID: 15252064] CrossrefMedlineGoogle Scholar6. Jensen CD, Corley DA, Quinn VP, Doubeni CA, Zauber AG, Lee JK, et al. Fecal immunochemical test program performance over 4 rounds of annual screening: A retrospective cohort study. Ann Intern Med. 2016;164:456-63. [PMID: 26811150]. doi:10.7326/M15-0983 LinkGoogle Scholar7. Selby K, Jensen CD, Lee JK, Doubeni CA, Schottinger JE, Zhao WK, et al. Influence of varying quantitative fecal immunochemical test positivity thresholds on colorectal cancer detection. A community-based cohort study. Ann Intern Med. 2018. [Epub ahead of print]. doi:10.7326/M18-0244 LinkGoogle Scholar8. Doubeni CA, Corley DA, Quinn VP, Jensen CD, Zauber AG, Goodman M, et al. Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: a large community-based study. Gut. 2018;67:291-298. [PMID: 27733426] doi:10.1136/gutjnl-2016-312712 CrossrefMedlineGoogle Scholar9. Imperiale TF, Ransohoff DF, Itzkowitz SH, Levin TR, Lavin P, Lidgard GP, et al. Multitarget stool DNA testing for colorectal-cancer screening. N Engl J Med. 2014;370:1287-97. [PMID: 24645800] doi:10.1056/NEJMoa1311194 CrossrefMedlineGoogle Scholar10. Doubeni CA, Gabler NB, Wheeler CM, McCarthy AM, Castle PE, Halm EA, et al. Timely follow-up of positive cancer screening results: A systematic review and recommendations from the PROSPR Consortium. CA Cancer J Clin. 2018;68:199-216. [PMID: 29603147] doi:10.3322/caac.21452 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania, Philadelphia, Pennsylvania (C.A.D.)Kaiser Permanente Medical Center, Walnut Creek, California (T.R.L.)Disclaimer: Dr. Doubeni is a member of the U.S. Preventive Services Task Force (USPSTF). This article does not necessarily represent the views and policies of the USPSTF.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2444.Corresponding Author: Chyke A. Doubeni, MD, MPH, University of Pennsylvania, Perelman School of Medicine, 3930 Chestnut Street, 1st Floor, Philadelphia, PA 19104; e-mail, chyke.[email protected]upenn.edu.Current Author Addresses: Dr. Doubeni: University of Pennsylvania, Perelman School of Medicine, 3930 Chestnut Street, 1st Floor, Philadelphia, PA 19104.Dr. Levin: Gastroenterology Department, Kaiser Permanente Medical Center, 1425 South Main Street, Walnut Creek, CA 94596.This article was published at Annals.org on 2 October 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDivergent Long-Term Detection Rates of Proximal and Distal Advanced Neoplasia in Fecal Immunochemical Test Screening Programs Manuel Zorzi , Cesare Hassan , Giulia Capodaglio , Elena Narne , Anna Turrin , Maddalena Baracco , Antonella Dal Cin , Annarita Fiore , Giancarla Martin , Alessandro Repici , Douglas Rex , and Massimo Rugge Metrics Cited byOptimizing the colorectal cancer screening programme using faecal immunochemical test (FIT) in Flanders, Belgium from the "interval cancer" perspectiveA user-friendly objective prediction model in predicting colorectal cancer based on 234 044 Asian adults in a prospective cohortThe effect of using fecal testing after a negative sigmoidoscopy on the risk of death from colorectal cancerInformation on Colon Polyps in Terms of Gastroenterology 6 November 2018Volume 169, Issue 9Page: 650-651KeywordsAttentionCancer screeningColonColonoscopyColorectal cancerDisclosureHemoglobinInterquartile rangeLesionsRectum ePublished: 2 October 2018 Issue Published: 6 November 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...