- A single fecal immunochemical test (FIT) demonstrated moderate to high specificity and sensitivity for colorectal cancer (CRC), but low sensitivity for advanced adenomas in a large meta-analysis of asymptomatic, average-risk adults.
Why this matters
- FIT has the potential to increase CRC screening rates in the United States.
- Systematic review and meta-analysis of 31 articles (n=120,255) that included 18 FITs.
- Funding: Indiana University.
- The most commonly studied FIT was OC-Sensor (Eiken Chemical, 58% of studies).
- CRC sensitivity/specificity by threshold:
- 10 µg/g: sensitivity, 0.91 (95% CI, 0.84-0.95); negative likelihood ratio, 0.10 (95% CI, 0.06-0.19).
- >20 µg/g: specificity, 0.95 (95% CI, 0.94-0.96); positive likelihood ratio, 15.49 (95% CI, 9.82-22.39).
- Advanced adenoma sensitivity/specificity by threshold:
- 10 µg/g: sensitivity, 0.40 (95% CI, 0.33-0.47); negative likelihood ratio, 0.67 (95% CI, 0.57-0.78).
- >20 µg/g: specificity, 0.95 (95% CI, 0.94-0.96); positive likelihood ratio, 5.86 (95% CI, 3.77-8.97).
- For CRC, at a threshold of 10 µg/g, 1 qualitative FIT had a sensitivity of 0.90 and a specificity of 0.91, with a positive likelihood ratio of 10.13 and a negative likelihood ratio of 0.11.
- Study included only 1-time testing, not serial testing.