We read with interest the article by Cross et al ,1 which examined the use of FIT in intermediate risk patients undergoing 3 yearly surveillance colonoscopies. The investigators assessed the diagnostic accuracy of this approach, together with the number of advanced adenomas and colorectal cancers missed, and the potential cost savings. The results indicate that replacing 3 yearly colonoscopy with annual FIT (with a positivity threshold of 40 µg Hb/g faeces) would result in cost savings over the screening cycle of £4.7 million reflecting an 87% reduction in colonoscopies. However, such an approach would miss up to 41% of interval cancers and 67% of advanced adenomas. Modelling a lower FIT positivity threshold (10 µg Hb/g faeces) suggests that the strategy would reduce colonoscopies by 71% but would still miss 28% of cancers and 43% of advanced adenomas. …

中文翻译：

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通过粪便免疫化学测试减少监测结肠镜检查的数量

我们饶有兴趣地阅读了 Cross 等人 1 的文章，该文章研究了 FIT 在接受 3 年一次结肠镜检查的中等风险患者中的应用。研究人员评估了这种方法的诊断准确性，以及漏诊的晚期腺瘤和结直肠癌的数量，以及潜在的成本节约。结果表明，用每年一次的 FIT（阳性阈值为 40 µg Hb/g 粪便）代替 3 年一次的结肠镜检查将在筛查周期中节省 470 万英镑的成本，反映出结肠镜检查减少了 87%。然而，这种方法将错过高达 41% 的间期癌和 67% 的晚期腺瘤。对较低的 FIT 阳性阈值（10 µg Hb/g 粪便）进行建模表明，该策略将减少 71% 的结肠镜检查，但仍会漏掉 28% 的癌症和 43% 的晚期腺瘤。…