The benefits of using FIT for Colorectal Cancer Screening – the

experience of the Dutch Colorectal Cancer screening program

The high incidence and associated mortality, and the natural history of Colorectal Cancer (CRC) with slow progression from a premalignant polyp to cancer, makes CRC very suitable for population screening. It has already been shown that adenoma removal reduces the incidence of CRC by 76–90%, and almost completely prevents CRC mortality within the subsequent 10 years.

Various CRC screening tests are available, resulting in different approaches in different countries. Of the currently available screening tests, faecal occult blood tests (FOBT) and sigmoidoscopy are the only strategies that have been proven in prospective randomized controlled trials to reduce CRC-related mortality. The evidence favouring faecal immunochemical testing (FIT) over guaiac faecal occult blood testing (gFOBT) is substantial: FIT is more likely to detect haemoglobin from the lower GI-tract; FIT is also easier to use resulting in higher participation rates; FIT enables quantitative measuring faecal haemoglobin (Hb) allowing the use of different cut-off concentrations; and can be analysed by automation.

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