Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Date of Graduation
12-13-2025
Semester of Graduation
Fall
Course Instructor
Sharon Maiewski
Abstract
Abstract
Objectives
Colorectal cancer (CRC) is a leading cause of cancer-related deaths in the United States, with most cases occurring in individuals aged 50 years and older. Effective screening is essential for early detection and improved patient outcomes. This paper compares two widely used CRC screening methods—fecal immunochemical testing (FIT) and colonoscopy—primarily in terms of colorectal cancer detection, but also considers adherence and diagnostic yield.
Methods
A search was conducted using PubMed and CINAHL to identify relevant studies comparing FIT and colonoscopy. Articles were included if they were randomized controlled trials (RCTs) or clinical trials published after 2020, involved subjects aged 50 and older, and evaluated CRC detection rates as a primary outcome. After applying exclusion criteria, three studies were analyzed: the SCREESCO trial, the TARGET-C trial, and a study by Xu et al. These studies assessed CRC detection rates, advanced adenoma detection rates, adherence, and adverse events associated with each screening method.
Results
The reviewed studies demonstrated that FIT and colonoscopy have distinct advantages. FIT achieved higher participation rates, with adherence ranging from 55.5% to 99.3%, compared to colonoscopy adherence rates of 35.1% to 42.4%. FIT had a slightly higher CRC detection rate in the SCREESCO trial (0.20% vs. 0.16%) but a lower rate in the TARGET-C study (0.10% vs. 0.23%). Colonoscopy consistently outperformed FIT in detecting advanced adenomas, with rates of 2.05% to 2.76%, compared to FIT’s rates of 1.15% to 1.61%.
Conclusions
FIT and colonoscopy are both effective CRC screening tools, but their benefits vary. FIT’s non-invasive nature and higher adherence make it ideal for population-based screening programs, particularly when sustained participation is critical. In contrast, colonoscopy’s superior ability to detect advanced adenomas highlights its importance in comprehensive CRC prevention and for patients at higher risk. The choice of screening method should consider patient preferences, risk factors, and healthcare resource availability to optimize CRC detection and outcomes.
Recommended Citation
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