102P - Enhancing colorectal cancer prevention in high-risk populations through faecal immunochemical test surveillance

Background

In view of a higher likelihood of risk of having advanced adenoma or invasive cancer in the individual with above average, we investigated whether receiving subsequent faecal immunochemical tests (FITs) in the intervals between colonoscopies could reduce the risk of colorectal cancer (CRC) and advanced colorectal neoplasia (ACN) incidence.

Methods

A retrospective cohort study was performed among high-risk population for CRC between January 2012 and December 2022, in Tianjin, China. The incidence of CRC and ACN were calculated for the FIT surveillance and non-FIT surveillance groups and reported as the number of events per 100000 person-years. Cox proportional hazards model models were applied to evaluate the risks of CRC and ACN, with crude and adjusted hazard ratios (HRs) and 95% confidence intervals (CI).

Results

We included 12515 participants with a high risk of CRC, aged 40-74 years, of whom 4980 received subsequent FIT between colonoscopies during the study period. Among these participants, 51 CRC cases occurred in the non-FIT surveillance group (incidence rate, 233.88 per 100000 person-years) and there were 29 cases of CRC in the FIT surveillance group (incidence rate, 184.85 per 100000 person-years). The cumulative events of the advanced adenoma group were highest, followed by the non-advanced adenoma group, then the no neoplasia group stratified based on the prior colonoscopy findings. Compared with the non-FIT surveillance group, the FIT surveillance group had a 54% decreased risk of developing CRC (HR, 0.46; 95% CI, 0.29-0.74) and a 45% decreased risk of developing ACN (HR, 0.55; 95% CI, 0.47-0.64).

Conclusions

In this CRC surveillance program, our study found that high-risk participants who received subsequent FIT surveillance in the intervals between colonoscopy were associated with a reduction of CRC and ACN incidence, which indicated the value and utility of FIT in the surveillance program.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

This work was supported by the National Natural Science Foundation of China (Grant. No: 81973135 and 81972826) and Science and Technology Commission of Shanghai Municipality (Grant. No: 21XD1402600).

Disclosure

All authors have declared no conflicts of interest.