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Negative Fecal Immunochemical Test Results and Risk of Colorectal Cancer

By: Cordi Craig
Posted: Tuesday, March 26, 2019

Patients with fecal immunochemical test results below positivity thresholds, or ‘negative’ results, may be at an increased risk of advanced neoplasia and interval cancer, according to an analysis of a colorectal cancer screening program published in the European Journal of Cancer. Although little attention has been given to negative test results, “the results of this study could be used in the design of personalized screening strategies because it uses information readily available in all programs,” Andrea Buron, MD, PhD, of the Hospital del Mar, Barcelona and colleagues concluded.

“Future studies will address the risk of developing neoplasia related to [fecal immunochemical tests] under the threshold results, taking into account the effect of non-participation and longer follow-ups,” the investigators commented.

The authors categorized negative fecal immunochemical test results into nondetectable, low, and high across 2 screenings in more than 42,000 patients. They were included in a population-based colorectal cancer screening program.

More than 90% of the patient population had nondetectable test results in the first and second screenings, 4.5% and 5.8% had low results, and 2.2% and 2.9% had high results. The probability of being diagnosed with advanced neoplasia or interval cancer increased with increasing negative fecal immunochemical test results. Patients who had two consecutive high negative test results or one low and one high had the highest odds ratio (21.75 and 20.38, respectively) compared with those with two nondetectable results. Aside from age and sex, the authors suggest that quantitative values from negative test results should be included for personalized screening strategies.

Disclosure: The study authors reported no conflicts of interest.

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