Optimizing Fecal Immunochemical Testing For Colorectal Cancer Screening

Colorectal cancer (CRC) screening aims to detect CRC and its precursors in an early phase, thereby reducing disease burden. This field is evolving rapidly, with an emphasis on population coverage, quality assurance, new screening methods, and individualized screening. There are various screening modalities available, each with their advantages and disadvantages. Guaiac fecal occult blood test (gFOBT) and sigmoidoscopy are the only strategies supported by evidence from prospective randomized controlled trials with CRC-related mortality as the end point. Fecal immunochemical testing (FIT) has been introduced as an alternative to gFOBT. FIT is easier to use, leads to higher population participation, and has higher accuracy for advanced neoplasia and CRC than gFOBT. FIT thus is expected to outperform gFOBT screening significantly in reducing CRC incidence and mortality. Consequently, most national screening programs in Europe and Asia-Pacific use FIT as the primary method for population-based screening. [...]