Background and Aims

A fecal immunochemical test (FIT) is often repeated annually, even after a recent colonoscopy. However, there are no published data on the proper approach to FIT-positive patients after a recent colonoscopy. We compared colorectal cancer (CRC) and advanced colorectal neoplasia (ACRN) prevalence based on the interval since the last colonoscopy.

Methods

We reviewed asymptomatic screenees aged ≥50 years who underwent FIT and colonoscopy.

Results

Of 2228 FIT-positive participants, 514 had a colonoscopy less than 3 years before (group 1), 427 had a colonoscopy had a colonoscopy 3 to 10 years before (group 2), and 1287 had a colonoscopy >10 years before or no colonoscopy (group 3). The prevalence of CRC in groups 1, 2, and 3 was 2.1%, 1.6%, and 7.2%, respectively, and that for ACRN was 10.9%, 12.6%, and 26.0%, respectively. Even after adjusting for confounders, CRC and ACRN detection rates in group 1 were lower than those in group 3 but not lower than those in group 2. Among 6135 FIT-negative participants, the prevalence of CRC in the 3 groups was .7%, .4%, and 3.4%, respectively, and that for ACRN was 6.0%, 6.1%, and 14.7%, respectively. CRC and ACRN detection rates were significantly higher in FIT-positive participants than in FIT-negative participants in all 3 groups.

Conclusions

In FIT-positive patients who underwent colonoscopy within the prior 3 years, CRC and ACRN prevalence was not low. Our findings support the U.S. Multi-Society Task Force on the CRC screening recommendation that repeat colonoscopy be offered to patients with positive FIT results and recent colonoscopy.

中文翻译：

---

粪便免疫化学试验阳性和近期结肠镜检查在无症状个体中重复结肠镜检查的产率

背景和目标

即使最近进行了结肠镜检查，也经常每年进行一次粪便免疫化学测试（FIT）。但是，最近的结肠镜检查后，尚未有关于FIT阳性患者的正确治疗方法的公开数据。我们根据自上次结肠镜检查以来的时间间隔比较了大肠癌（CRC）和晚期大肠赘生物（ACRN）患病率。

方法

我们回顾了接受FIT和结肠镜检查的≥50岁无症状筛查者。

结果

在2228名FIT阳性参与者中，有514例在不到3年之前接受了结肠镜检查（第1组），有427例在3到10年之前接受了结肠镜检查（第2组），还有1287例在≥10年之前进行了结肠镜检查或没有进行过结肠镜检查（第3组）。第1、2和3组的CRC患病率分别为2.1％，1.6％和7.2％，而ACRN的患病率分别为10.9％，12.6％和26.0％。即使经过校正混杂因素，第1组的CRC和ACRN检出率仍低于第3组，但不低于第2组。在6135名FIT阴性参与者中，3组的CRC患病率为0.7％，分别为0.4％和3.4％，而ACRN的分别为6.0％，6.1％和14.7％。在所有3组中，FIT阳性参与者的CRC和ACRN检测率均显着高于FIT阴性参与者。

结论

在过去3年内接受结肠镜检查的FIT阳性患者中，CRC和ACRN的患病率并不低。我们的研究结果支持美国多社会工作组关于CRC筛查的建议，即向FIT结果阳性和近期结肠镜检查的患者提供重复结肠镜检查。