Colorectal cancer is preventable and treatable by screening and early detection. Fecal immunochemical tests (FIT) for average risk individuals is an effective strategy for screening. Incidence and mortality in Mexico is increasing and large-scale screening programs do not yet exist. The aim of this study was to evaluate the feasibility of FIT-based colorectal cancer screening program in Mexico City. For more than 15 months, average risk individuals in Mexico City were invited to participate at Mexico's Instituto Nacional de Cancerologia (INCan, Mexico City, Mexico). Participants received an FIT kit for stool collection, results ≥20 ng/mL were referred for high quality colonoscopy. Participants' results were classified according to the most advanced clinical finding as: adenocarcinoma, high-risk adenomas, low-risk adenomas, serrated lesions, hyperplastic polyps, and no polyps. Sequential analyses were performed to assess the positive predictive value (PPV) of FIT. A total of 810 participants were eligible, 737 (91.0%) returned the FIT and 112 (15.2%) had an abnormal result. Of these participants, 87 (77.7%) completed colonoscopy. Clinical findings of participants included: seven (8.1%) adenocarcinomas, 18 (20.7%) high-risk adenomas, 23 (26.4%) low-risk adenomas, one (1.2%) serrated lesions, 14 (16.1%) hyperplasic polyps, and 24 (27.6%) no polyps. The PPV of FIT using the ≥20 ng/mL was 8.1% for cancer and 20.7% for high-risk adenomas. In conclusion, colorectal cancer screening with FIT is feasible at INCan in Mexico City, where resources are available. Further studies are needed to determine feasibility of colorectal cancer screening in other settings, as well as optimal hemoglobin detection cut-off points to maximize the population benefits of colorectal cancer screening with FIT in Mexico.

中文翻译：

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大肠癌平均风险的墨西哥人群的粪便免疫学测试结果和诊断性结肠镜检查

通过筛查和早期发现，结直肠癌是可以预防和治疗的。平均风险个体的粪便免疫化学测试 (FIT) 是一种有效的筛查策略。墨西哥的发病率和死亡率正在增加，但尚不存在大规模筛查计划。本研究的目的是评估墨西哥城基于 FIT 的结直肠癌筛查计划的可行性。在超过 15 个月的时间里，墨西哥城的平均风险个人被邀请参加墨西哥国家癌症研究所（墨西哥墨西哥城 INCan）。参与者收到了用于粪便收集的 FIT 试剂盒，结果≥20 ng/mL 被转介进行高质量结肠镜检查。参与者的结果根据最先进的临床发现分为：腺癌、高危腺瘤、低危腺瘤、锯齿状病变、增生性息肉，无息肉。进行顺序分析以评估 FIT 的阳性预测值 (PPV)。共有 810 名参与者符合条件，737 名（91.0%）返回 FIT，112 名（15.2%）结果异常。在这些参与者中，87 人 (77.7%) 完成了结肠镜检查。参与者的临床发现包括：7 个 (8.1%) 腺癌、18 个 (20.7%) 高危腺瘤、23 个 (26.4%) 低危腺瘤、1 个 (1.2%) 锯齿状病变、14 个 (16.1%) 增生性息肉和24 (27.6%) 没有息肉。使用≥20 ng/mL 的 FIT 的 PPV 对于癌症为 8.1%，对于高危腺瘤为 20.7%。总之，在可用资源的墨西哥城 INCan 使用 FIT 进行结肠直肠癌筛查是可行的。需要进一步的研究来确定在其他环境中进行结肠直肠癌筛查的可行性，