ArticleCancer medicine2025
The Impact of Age on Preferences for Colorectal Cancer Surveillance Strategies: Are Fecal Immunochemical Tests FIT for Surveillance?
Article in Cancer medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionIndividuals with a known risk of colorectal cancer (CRC) are recommended regular surveillance colonoscopies. Alternative surveillance strategies incorporating fecal immunochemical tests (FIT) may improve colonoscopy resource utilization and be more appropriate for those with a lower risk of CRC, particularly younger adults. This study compared younger (< 50 years) and older (≥ 50 years) adults' preferences for different CRC surveillance strategies.
methodsEight hundred individuals enrolled in a colonoscopy-based surveillance program were invited to complete a survey assessing CRC surveillance preferences. Preferences for colonoscopy frequency and the acceptability of two alternative protocols were assessed: (1) providing FIT between colonoscopies, and (2) a FIT-only strategy where colonoscopy would only be required after a positive FIT result.
resultsA total of 102 younger (median age 41.4 years, 67.6% female) and 187 older (median age 68.5 years, 49.2% female) adults completed the survey. Surveillance preferences did not significantly vary by age group; most respondents preferred colonoscopies more often than their current frequency (< 50 years: 54.1%; ≥ 50 years: 58.1%). Although most participants (< 50 years: 91.2%; ≥ 50 years: 93.0%) agreed that FIT is important to complete between surveillance colonoscopies, only a small proportion were comfortable with FIT-only surveillance replacing colonoscopies (< 50 years: 27.5%; ≥ 50 years: 37.4%). Fear of CRC was a significant predictor of preferences for more frequent surveillance incorporating FIT in younger, but not older, adults.
conclusionMany individuals with an elevated risk of CRC wanted more frequent surveillance, regardless of their age. Extending surveillance colonoscopy intervals using FIT may be a more acceptable method of reducing colonoscopy frequency rather than utilizing a FIT-only approach.
trial registrationThis study was prospectively registered with the Australian New Zealand Clinical Trials Registry (ACTRN #12619001743156).
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