COMMENTARY

FIT in CRC Screening: A Good Strategy Even in Patients on NSAIDs

Charles P. Vega, MD

Disclosures

July 25, 2018

Hello. I'm Dr Charles Vega, and I am a clinical professor of family medicine at the University of California at Irvine. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

Anticoagulants and nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, do not affect the accuracy of fecal immunochemical tests (FITs) used to screen for colorectal cancer (CRC). That was the conclusion of a first-ever meta-analysis and systematic review of use of FITs in patients taking anticoagulants.

Earlier research had led to concern that use of these drugs could contribute to false-positive results of fecal blood tests., so the new data are reassuring.

The American Cancer Society recently issued a recommendation to begin CRC screening at age 45 rather than age 50, using either a FIT or a visual exam. FIT testing is now the predominant mode of CRC screening worldwide. And screening guidelines do not provide recommendations on the use of anticoagulants and NSAIDs at the time of FIT sampling. Now we can more confidently employ this less invasive screening strategy.

One warning: We can't assume that the findings here apply to patients with symptoms suggestive of bowel cancer, and FIT tests are not appropriate for these patients.

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