Is There an Increased Risk of Proximal Neoplasia in Colon for Patients with Positive FIT?

de Klaver W, van der Vlugt M, Spaander MCW, Bossuyt PM, Dekke E. Risk of Cancers Proximal to the Colon in Fecal Immunochemical Test Positive Screenees in a Colorectal Cancer Screening Program. Gastroenterology. 2004;167:788-797.

De Klaver and coauthors used data from a national database in the Netherlands to determine the risk for proximal digestive tract neoplasms in patients who had a positive fecal immunochemical test (FIT) followed by a negative colonoscopy, patients who had advanced colonic neoplasia discovered on colonoscopy, and patients who had a negative FIT.

At 3 years of follow up, proximal advanced neoplasms had been diagnosed in less than 1% of all patient groups. The risk for proximal neoplasia was significantly higher in patients with positive FIT, but because the overall risk was small, the authors concluded that specific diagnostic studies to detect proximal digestive tract neoplasms were not indicated for patients with positive FIT tests.