Mailed Fecal Immunochemical Tests—From Efficacy to Implementation
Mené aux Etats-Unis auprès de 20 250 patients bénéficiant de soins dans un centre de santé communautaire (âge : de 50 à 75 ans), cet essai randomisé évalue, par rapport aux soins usuels et du point de vue de la proportion de personnes ayant participé au dépistage du cancer colorectal, l'efficacité d'une intervention centralisée annuelle menée sur trois ans et comprenant l'envoi postal de tests FIT, l'envoi de brochures d'information et des relances téléphoniques
Fecal immunochemical tests (FITs) are an established tool for population-level cancer prevention owing to several complementary features. Repeated testing offers multiple opportunities to catch lesions early, reducing not just colorectal cancer (CRC) mortality, but also CRC incidence itself. FITs are also cheap, noninvasive, and highly specific; during 10 years of FIT screening, approximately 80% of participants never need a diagnostic colonoscopy. Additionally, because human hemoglobin remains stable in buffer for weeks at varying temperatures, kits can be mailed to a central laboratory rather than requiring an in-person visit. This logistical simplicity makes FITs amenable to mailed outreach, and multiple randomized clinical trials have shown that mailing FIT kits to people overdue for CRC screening increases participation, particularly among underserved populations. We are still learning, however, how to implement FIT outreach more widely.
JAMA Network Open , éditorial en libre accès, 2026