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• W3093626097 abstract "INTRODUCTION: Colorectal cancer (CRC) is a significant contributor to cancer related morbidity and mortality.Evidence based practice guidelines from the MSTF endorse both colonoscopy and fecal immunochemical testing (FIT) as Tier 1 screening tests.FIT is endorsed due to its sensitivity (79%) which is repeated yearly, high specificity (94%) and low cost ($20).Tier 2 tests include Multitarget Stool DNA (FIT- fecal DNA) testing whose disadvantages include variable specificity which has been shown to decrease with age (83%), and high cost ($500–600).We examined usage patterns of screening tests used in our health system as well as colonoscopy results following a positive FIT or FIT-fecal DNA test. METHODS: A retrospective cohort study of patients was performed and those who underwent colonoscopy for positive FIT or FIT-fecal DNA test from 10/1/18 to 12/31/19 were identified from our departmental registry. Results were analyzed for presence of high risk lesions in both populations. Furthermore, we examined patterns of usage of each test among referring physicians. RESULTS: 236 patients were identified. 9.7% (n = 23) of patients were referred for positive FIT, and 90.2% (n = 213) for FIT-fecal DNA testing. Pathologic and demographic data are listed in Figures 1 and 2, respectively. Only 63 patients (29.6%) were found to have a high risk lesion on colonoscopy after positive FIT-fecal DNA test compared to 8 patients (34.8%) with a positive screening FIT.128 FIT-fecal DNA tests (60.1%) were ordered by PCPs and gynecologists within our Network. Interestingly, 21 patients had FIT or FIT-fecal DNA performed in the setting of previously known high risk lesion.Figure 1.: Colonoscopy findings after Positive Multitarget Stool DNA and FIT Testing.Figure 2.: Patient Demographics.CONCLUSION: Although MSTF guidelines endorse FIT and colonoscopy as tier 1 screening tests for CRC screening, there seems to be a large number of physicians who prefer FIT-fecal DNA testing instead of FIT as the first choice test. From our results, it is clear that approximately 2/3 of FIT fecal DNA tests showed no significant abnormality. Our low numbers for FIT are certainly limited due to overall minimal usage. In addition, the role of repeat FIT testing is unclear after screening colonoscopy.Based on the above findings, education sessions via webinars and medical grand rounds were held for PCPs and gynecologists discussing the evidence behind accuracy of various screening tests and cost including the recommendation by MSTF to provide FIT as a first option for screening when colonoscopy is deferred by a patient." @default.
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• W3093626097 date "2020-10-01" @default.
• W3093626097 modified "2023-10-14" @default.
• W3093626097 title "S3129 Colon Cancer Screening Patterns Within a Large Health Network: What Is the Reality?" @default.
• W3093626097 doi "https://doi.org/10.14309/01.ajg.0000714564.56007.5f" @default.
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