Effectiveness of the immunochemical fecal test (FIT) for detection of advanced adenomas in colorectal carcinoma screening in an asymptomatic population.

AIM The aim of the study was to evaluate the benefit of the immunochemical fecal blood test (FIT) for detection of advanced adenomas. MATERIAL AND METHODS We have conducted a screening study on a average-risk cohort of subjects, aged 50 -74 years. We used a rapid quantitative FIT to perform the screening. Colonoscopy was recommended in all participants with positive FIT. We assessed the participation rate and analyzed advanced adenomas detected in the screening examinations. RESULTS Our study enrolled 1111 asymptomatic participants. Immunochemical test results were positive in 72 subjects (6.5%). Colonoscopy was performed by 50/72 (69.4%) subjects. The detection rate for advanced adenomas was 2.2%. A total number of 28 advanced adenomas were detected in 24 subjects, meaning 1.2 advanced adenoma/subject. Analyzing the 3 characteristics of advanced adenomas, we observed in our study that 25/28 adenomas (89.3%) had sizes > or = 10 mm, 11/28 adenomas (39.3%) were tubulovillous/villous and 19/28 adenomas (67.9%) had high dysplasia. The majority of advanced adenomas were found in the left colon as compared to the right colon: 71.4% vs. 28.6%. p = 0.0008. CONCLUSIONS In our study was obtained a 2.2% detection rate for advanced adenomas, most of them (71.4%) being located in the left colon. The dominant feature of advanced adenomas detected was the size > or = 10 mm (89.3% of cases).