Performance of the Fecal Immunochemical Test in Detecting Advanced Colorectal Neoplasms and Colorectal Cancers in People Aged 40–49 Years - A Systematic Review and Meta-Analysis

Q: What screening strategy does the study evaluate for people aged 40–49?

It evaluates fecal immunochemical tests (FIT) as a screening approach to detect advanced colorectal neoplasms and colorectal cancer in individuals aged 40–49.

Q: How many studies and FIT tests were included in the meta-analysis?

Ten studies were included, totaling 664,159 FIT tests.

Q: What do the findings say about FIT-positive individuals in the 40–49 group?

FIT-positive individuals aged 40–49 had significantly higher odds of advanced colorectal neoplasms and colorectal cancer than the average-risk group, regardless of FIT results.

Sep 24, 2026

Uploaded by Margaret

The incidence of early-onset colorectal cancer is increasing, and many guidelines recommend beginning screening at age 45. This systematic review and meta-analysis evaluates fecal immunochemical tests (FITs) for detecting advanced colorectal neoplasms (ACRN) and colorectal cancer (CRC) in individuals aged 40–49 versus an average-risk group of 50 years or older. Ten studies (664,159 FITs) were included. Results show FIT positivity of 4.9% in the younger group and 7.3% in the average-risk group, with higher ACRN/CRC risks in FIT-positive younger participants. The study concludes that FIT-based detection rates are acceptable for ages 40–49 and that ACRN yield may be similar for 45–49 and 50–59, supporting further prospective and cost-effectiveness research.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Introduction

Methods

Results

Detection rates and positivity by age group

Risk estimates for ACRN and CRC

Conclusion

cancers Systematic Review Performance of the Fecal Immunochemical Test in Detecting Advanced Colorectal Neoplasms and Colorectal Cancersin People Aged 40–49 Years: A Systematic Review and Meta-Analysis Jen-Hao Yeh 1,2,3, Cheng-Hao Tseng 4, Wen-Lun Wang 4, Chih-I Chen 5, Yu-Peng Liu 3,6, Yi-Chia Lee 7, Jaw-Yuan Wang 3,8,9,10,11, *,† and Yu-Ching Lin 12, *,† Citation: Yeh, J.-H.; Tseng, C.-H.; Wang, W.-L.; Chen, C.-I.; Liu, Y.-P.; Lee, Y.-C.; Wang, J.-Y.; Lin, Y.-C. Performance of the Fecal Immunochemical Test in Detecting Advanced Colorectal Neoplasms and Colorectal Cancers in People Aged 40–49 Years: A Systematic Review and Meta-Analysis. Cancers 2023, 15, 3006. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)cancers15113006 Academic Editors: Eduardo Redondo-Cerezo and Julio Iglesias-Garcia Received: 19 April 2023 Revised: 24 May 2023 Accepted: 28 May 2023 Published: 31 May 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-DA DaChang Hospital, I-Shou University, Kaohsiung 813, Taiwan; [b9202078@gmail.com](b9202078@gmail.com) 2 Department of Medical Technology, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan 3 Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung 813, Taiwan; [ypliu@kmu.edu.tw](ypliu@kmu.edu.tw) 4 Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-DA Cancer Hospital, Kaohsiung 824, Taiwan; [chenhaug@gmail.com](chenhaug@gmail.com) (C.-H.T.); [warrengodr@gmail.com](warrengodr@gmail.com) (W.-L.W.) 5 Division of Colorectal Surgery, Department of Surgery, E-DA Hospital, Kaohsiung 824, Taiwan; [jimmyee0901@gmail.com](jimmyee0901@gmail.com) 6 Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 813, Taiwan 7 Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan; [yichialee@ntu.edu.tw](yichialee@ntu.edu.tw) 8 Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 813, Taiwan 9 Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 813, Taiwan 10 Center for Cancer Research, Kaohsiung Medical University, Kaohsiung 813, Taiwan 11 Pingtung Hospital, Ministry of Health and Welfare, Pingtung 900, Taiwan 12 Department of Family Medicine, E-DA DaChang Hospital, I-Shou University, Kaohsiung 824, Taiwan * Correspondence: [cy614112@ms14.hinet.net or jayuwa@cc.kmu.edu.tw](cy614112@ms14.hinet.net or jayuwa@cc.kmu.edu.tw) (J.-Y.W.); yukingyclin@gmail.com or [ed106199@edah.org.tw](ed106199@edah.org.tw) (Y.-C.L.); Tel.: +886-7-3122805 (J.-Y.W.); +886-7-5599123 (Y.-C.L.)† These authors contributed equally to this work. Simple Summary: Recently, the cases of colorectal cancers has been rising in younger age (<50) individuals. Although current guidelines recommend colorectal cancer screening should be initiated at age 45 instead of 50, the optimal approach of colorectal cancer screening is not clear. This article investigates the efﬁcacy of fecal immunochemical test (FIT), which detects occult blood in stool, in predicting advanced colorectal polyps and tumors among people aged 40–49 . The ﬁndings suggest FIT is useful to identify such people with high risk to have advanced colorectal lesions. Hence, FIT may be considered as the ﬁrst-line screening tool for these people, and further comparative study between FIT and colonosco

FAQs

What screening strategy does the study evaluate for people aged 40–49?

It evaluates fecal immunochemical tests (FIT) as a screening approach to detect advanced colorectal neoplasms and colorectal cancer in individuals aged 40–49.

How many studies and FIT tests were included in the meta-analysis?

Ten studies were included, totaling 664,159 FIT tests.

What do the findings say about FIT-positive individuals in the 40–49 group?

FIT-positive individuals aged 40–49 had significantly higher odds of advanced colorectal neoplasms and colorectal cancer than the average-risk group, regardless of FIT results.

Sep 24, 2026

Uploaded by Margaret