JAMA Oncol

Early FIT screening may cut colorectal cancer incidence, mortality

June 18, 2025

Study details: This large, population-based cohort study from Taiwan assessed the long-term effectiveness of initiating fecal immunochemical test (FIT) screening for colorectal cancer (CRC) in adults aged 40 to 49, compared with the standard starting age of 50+. Using a delay-screen design and propensity score–matched analysis, researchers evaluated CRC incidence and mortality outcomes over time.

Results: Of 263,125 included participants, 39,315 participated in early and regular screening and 223,810 participated in regular screening only. Initiating FIT screening at age 40 to 49 was associated with lower CRC incidence (26.1 vs 42.6 per 100,000 person-years) and lower CRC mortality (3.2 vs. 7.4 per 100,000 person-years) compared with starting at age 50. Adjusted relative risks (aRR) showed a 21% reduction in CRC incidence (aRR 0.79; 95% confidence interval [CI], 0.67–0.94) and a 39% reduction in CRC mortality (aRR 0.61; 95% CI, 0.38–0.98). Extended analyses confirmed a 25% reduction in incidence and 34% reduction in mortality.

Clinical impact: These findings support reconsidering current CRC screening guidelines to begin FIT screening before age 50, particularly in populations with rising early-onset CRC rates. Early detection through noninvasive testing could lead to substantial public health gains by reducing preventable cancer burden in younger adults.

Source:

Chiu HM, et al. (2025, June 12). JAMA Oncol. Long-Term Effectiveness Associated With Fecal Immunochemical Testing for Early-Age Screening. https://pubmed.ncbi.nlm.nih.gov/40504543/