A new study published online in JAMA Oncology suggests that starting fecal immunochemical test (FIT) screening at ages 40-49 is associated with lower colorectal cancer (CRC) mortality and incidence compared to the current recommended age of 50. Researchers conducted an exploratory initiative in Taiwan, offering FIT screening to residents aged 40-49 years in two municipalities. The study found that early screening significantly reduced CRC incidence by 26.1 per 100,000 person-years and mortality by 3.2 per 100,000 person-years.
The study analyzed a community-based FIT screening cohort of over 500,000 Taiwanese residents between 2001 and 2009. Participants who underwent both early and regular screening had lower CRC incidence and mortality compared to those who only received regular screening. The findings persisted in propensity score-matched analyses and an extended nonadherence adjustment model.
The authors concluded that FIT screening at ages 40-49 is cost-effective and can reduce CRC cases, making it a valuable tool for public health benefits. However, the study’s limitations emphasize the need for external validation of the findings in different countries.
The results add to the growing body of observational studies suggesting that initiating screening at an age younger than 50 may lead to public health benefits. As such, these findings will be essential for informing policy and practice until randomized clinical trials are conducted.
Source: https://www.medscape.com/viewarticle/early-fit-screening-tied-big-reduction-crc-mortality-2025a1000fs4