A Tailored FIT for Improved Colorectal Cancer Screening
Authors: Jason A. Dominitz
Journal: Annals of Internal Medicine (2021)

EditorialsSeptember 2021A Tailored FIT for Improved Colorectal Cancer ScreeningJason A. Dominitz, MD, MHSJason A. Dominitz, MD, MHSNational Gastroenterology and Hepatology Program, Veterans Health Administration Washington, DCSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-2748 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Colorectal cancer (CRC) is a quintessential example of a condition meriting screening on the basis of the burden of disease and availability of acceptable screening tests that are not only effective at reducing CRC incidence and death but are also cost-effective (1). The wide array of recommended tests reflects the fact that none are clearly established as the “best”. Each test has its own strengths and limitations, including burden on the screenee, harms, costs, and efficacy (2). Options range from noninvasive stool-based tests (for example, fecal immunochemical test [FIT] and stool DNA tests combined with FIT) to invasive direct visualization ...References1. Ladabaum U, Dominitz JA, Kahi C, et al. Strategies for colorectal cancer screening. Gastroenterology. 2020;158:418-432. [PMID: 31394083] doi:10.1053/j.gastro.2019.06.043 CrossrefMedlineGoogle Scholar2. Davidson KW, Barry MJ, Mangione CM, et al; US Preventive Services Task Force. Screening for colorectal cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021;325:1965-1977. [PMID: 34003218] doi:10.1001/jama.2021.6238 CrossrefMedlineGoogle Scholar3. Rex DK, Boland CR, Dominitz JA, et al. Colorectal cancer screening: recommendations for physicians and patients from the U.S. Multi-Society Task Force on Colorectal Cancer. Gastroenterology. 2017;153:307-323. [PMID: 28600072] doi:10.1053/j.gastro.2017.05.013 CrossrefMedlineGoogle Scholar4. Imperiale TF, Gruber RN, Stump TE, et al. Performance characteristics of fecal immunochemical tests for colorectal cancer and advanced adenomatous polyps: a systematic review and meta-analysis. Ann Intern Med. 2019;170:319-329. [PMID: 30802902]. doi:10.7326/M18-2390 LinkGoogle Scholar5. Imperiale TF, Ransohoff DF, Itzkowitz SH, 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 Scholar6. Lansdorp-Vogelaar I, Goede SL, Bosch LJW, et al. Cost-effectiveness of high-performance biomarker tests vs fecal immunochemical test for noninvasive colorectal cancer screening. Clin Gastroenterol Hepatol. 2018;16:504-512.e11. [PMID: 28733262] doi:10.1016/j.cgh.2017.07.011 CrossrefMedlineGoogle Scholar7. de Klaver W, Wisse PHA, van Wifferen F, et al. Clinical validation of a multitarget fecal immunochemical test for colorectal cancer screening. A diagnostic test accuracy study. Ann Intern Med. 2021;174:1224-31. doi:10.7326/M20-8270 Google Scholar8. Lew JB, Greuter MJE, Caruana M, et al. Validation of microsimulation models against alternative model predictions and long-term colorectal cancer incidence and mortality outcomes of randomized controlled trials. Med Decis Making. 2020;40:815-829. [PMID: 32845232] doi:10.1177/0272989X20944869 CrossrefMedlineGoogle Scholar9. Grobbee EJ, Lam SY, Fuhler GM, et al. First steps towards combining faecal immunochemical testing with the gut microbiome in colorectal cancer screening. United European Gastroenterol J. 2020;8:293-302. [PMID: 32213018] doi:10.1177/2050640619890732 CrossrefMedlineGoogle Scholar10. Robertson DJ, Dominitz JA. When results from multitarget DNA tests are positive and colonoscopy is negative, should we be concerned about cancer outside the colon? [Editorial]. Clin Gastroenterol Hepatol. 2020;18:783-786. [PMID: 31626977] doi:10.1016/j.cgh.2019.10.016 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: National Gastroenterology and Hepatology Program, Veterans Health Administration Washington, DCDisclaimer: This material is the result of work supported in part by resources from the Veterans Health Administration. The content is solely the responsibility of the author and does not represent the views of the U.S. Department of Veterans Affairs or the U.S. government.Disclosures: The author has reported no disclosures of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-2748.Corresponding Author: Jason A. Dominitz, MD, MHS, University of Washington School of Medicine, 111-S-Gastro, VA Puget Sound Health Care System, 1660 South Columbian Way, Seattle, WA 98108; e-mail, Jason.[email protected]gov.This article was published at Annals.org on 20 July 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClinical Validation of a Multitarget Fecal Immunochemical Test for Colorectal Cancer Screening Willemijn de Klaver , Pieter H.A. Wisse , Francine van Wifferen , Linda J.W. Bosch , Connie R. Jimenez , René W.M. van der Hulst , Remond J.A. Fijneman , Ernst J. Kuipers , Marjolein J.E. Greuter , Beatriz Carvalho , Manon C.W. Spaander , Evelien Dekker , Veerle M.H. Coupé , Meike de Wit , and Gerrit A. Meijer Metrics Cited byThe multitarget fecal immunochemical test versus the fecal immunochemical test for programmatic colorectal cancer screening: a cross-sectional intervention study with paired design September 2021Volume 174, Issue 9Page: 1315-1316KeywordsColorectal cancerColorectal cancer screeningColorectal neoplasiaMulti target fecal immunochemical test ePublished: 20 July 2021 Issue Published: September 2021 PDF downloadLoading ...