Donella Puliti, Giuseppe Gorini, Adele Caldarella, Teresa Intrieri, Zhanna Tumanova, Gianfranco Manneschi, Carmen Beatriz Visioli, Beatrice Mallardi, Francesca Battisti, Simonetta Bisanzi, Cristina Sani, Giovanna Masala, Marco Zappa, Paola Mantellini
While increasing screening intensity would require more colonoscopies, extending the screening interval for individuals <60 years with undetectable f-Hb, could allow for the reallocation of colonoscopy resources.
INTRODUCTION AND AIM: To evaluate whether a risk-stratified colorectal cancer (CRC) screening approach based on a single faecal immunochemical test (FIT) performed better than one using two consecutive tests.
METHODS: Approximately 420,000 negative FIT results (positivity cut-off: 20 µg faecal haemoglobin, f-Hb/g) were collected between 2000 and 2015 within the Florence screening program.
RESULTS: The 3-year CRC risk was 15.9‰ in individuals with 15-20 µg/g on a single test, and 9.36‰ for those with a cumulative f-Hb concentration of 20-40 µg/g across two tests.
DISCUSSION: The two-tests approach showed lower discriminatory capacity in identifying the highest-risk subgroup compared to a single test. Screenees with 15-20 µg/g accounted for <1%, but faced a significantly increased 3-year CRC risk.
CONCLUSION: While increasing screening intensity would require more colonoscopies, extending the screening interval for individuals <60 years with undetectable f-Hb, could allow for the reallocation of colonoscopy resources.