From Positive FIT Result to Colonoscopy—Closing a Gap in Care
A partir d'une revue systématique de la littérature publiée jusqu'en mai 2026 (21 études incluant au total 19 613 patients ; âge : 50 à 75 ans ; 58,7 % d'hommes), cette méta-analyse évalue l'efficacité d'interventions pour améliorer le taux de réalisation des coloscopies après un test FIT ou FOBT dont les résultats se sont avérés anormaux
Colorectal cancer screening is effective, yet underused. Fortunately, patients have a variety of options. They can select screening colonoscopy as the initial step, which offers the greatest sensitivity for advanced neoplasia, or take a 2-step approach that begins with a stool test. An advantage of the stool tests, such as the fecal immunochemical test (FIT), is that 9 out of 10 patients will have a negative test result and will not require a follow-up colonoscopy.But the key to clinical benefit of stool-based testing lies with the subgroup with positive test results—these are patients who are at highest risk of having an early-stage cancer or advanced adenoma. Unfortunately, prior studies have found that follow-up colonoscopy rates after a positive stool test result are suboptimal, hovering around 50% in many instances. Many of the patients at highest risk are not getting the evaluation they need.
JAMA Internal Medicine , éditorial, 2026