Among the many types of colon cancer screenings, the fecal immunochemical test is quite common. Some of the benefits of this test are that it is non-invasive, and it is less expensive than a colonoscopy. There are certain drawbacks as well, though. A colonoscopy provides prevention, diagnosis and treatment in a single procedure because a doctor can visualize the colon, detect colon disease and remove polyps during the exam. A fecal immunochemical test simply evaluates a stool sample; a positive test requires a diagnostic colonoscopy.
According to new studies, patients with a positive fecal immunochemical test should get a colonoscopy as early as possible. Senior investigator Douglas Corley, M.D., Ph.D., from Kaiser Permanente in Oakland, California, says that this recent research gives “a solid evidence-based structure” to assist patients and physicians in follow-up and the development of much-needed guidelines. As of now, doctors and researchers do not know much information about the consequences of various follow-up times.
Dr. Corley and his research team analyzed data from members of the Kaiser Permanente Northern California and Southern California health plans. They selected 71,439 patients between the ages of 50 and 75 with positive fecal immunochemical tests.
The risks for any colorectal cancer and higher-stage disease were similar when the diagnostic colonoscopy was done 8 to 30 days, 31 to 60 days, 61 to 90 days, or 91 to 180 days after a positive fecal immunochemical test. After the six-month mark, there was a change. When the diagnostic colonoscopy was done between 181 to 365 days after a positive test, the risk increased for higher-stage colon cancer and the risk for any colorectal cancer. When the colonoscopy was done past 365 days, the risk for higher-stage cancers and the risk for any colorectal cancer doubled.
Dr. Corley concluded that a colonoscopy should be completed within six months after a positive fecal immunochemical test. Patients between 61 and 75 years of age should be tested within three months of a positive test because they have a high age-related risk for colon cancer and are less likely to have a false-positive test.
Even though it makes sense to schedule a colonoscopy after a positive fecal immunochemical test, there are several factors that might cause patients to delay. Some patients may delay because of fear or uncertainty, while others may delay because of the bowel prep or hassle of taking a day off work. In other situations, it might just be the logistics of the healthcare system and the multiple steps required for scheduling.
"Each step may take days to weeks, and cumulatively, between the positive test and completion of colonoscopy, a substantial amount of time can elapse. Along the way, there is always the potential for the next step not to happen," Dr. Corley pointed out (Source: Medscape).
The time interval between a positive stool test and a diagnostic colonoscopy is certainly important, and this study provides clear evidence that colon cancer can progress quickly. If you have had a positive stool test, do not delay in scheduling a follow-up procedure. If you need to find a screening center in your area, please use our convenient Locator tool.