SCREENING for bowel cancer using at-home faecal immunochemical tests could help to reduce the frequency of colonoscopies for some at above-average risk individuals, with a new study finding there is a low risk of advanced tumours following multiple negative tests.
"Due to the risks, costs and burden on the healthcare system from surveillance colonoscopies for bowel cancer, we need to explore how we can further personalise screening intervals," said study lead author Dr Molla Wassie, an NHMRC Emerging Leadership Fellow in the Flinders Health and Medical Research Institute.
"While people at a high-risk are encouraged to undertake surveillance colonoscopies every one to five years depending on their family history and prior colonoscopy results, faecal immunochemical tests could be one way of identifying those who could extend their surveillance interval out further."
Published in pre-print in the journal Clinical Gastroenterology and Hepatology, the team conducted a retrospective study of more than 3,300 individuals enrolled in the Southern Cooperative Program for the Prevention of Colorectal Cancer.
The participants had no bowel cancer found in their previous colonoscopy and were asked to have another in three to five years, while also being sent a faecal immunochemical test annually.
"We found the risk of the follow-up colonoscopy identifying advanced neoplastic lesions including cancer following a negative FIT was around one in 10, with this risk decreasing further with every subsequent negative result, with the risk only 5.7% after four negative tests," said Dr Wassie.
The authors say this supports the use of faecal immunochemical tests in individual cases and reduces overall frequency of colonoscopies.
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