• J Gen Intern Med · Feb 2020

    Premature Fecal Immunochemical Testing in British Columbia Canada: a Retrospective Review of Physician and Screening Participant Characteristics.

    • David Sanders, Brendan Bakos, Laura Gentile, and Jennifer J Telford.
    • University of British Columbia, Vancouver, Canada. David.sanders@alumni.ubc.ca.
    • J Gen Intern Med. 2020 Feb 1; 35 (2): 444448444-448.

    BackgroundColorectal cancer (CRC) screening is an evidence-based strategy to reduce CRC-related mortality.ObjectiveThis study identifies physician and participant characteristics, as well as previous FIT values associated with premature FIT usage.DesignThis is a retrospective review of all FITs ordered from January 1, 2016, until June 30, 2017. For each ordered FIT, the participant's chart was reviewed to identify if a previous FIT had occurred in the prior 21 months. A premature FIT was defined as an ordered test with a negative FIT in the preceding 21 months.ParticipantsScreening participants were average risk for CRC, aged 50-74, and had a FIT ordered by their primary care provider in British Columbia, Canada.Main MeasuresThe BC College of Physicians and Surgeons' database was used to identify the location of referring physician, date of graduation from medical school, and gender. The participant's age, gender, and value of previous FIT were recorded. Physician and participant variables and previous FIT value were examined with logistic regression to identify associations with premature FIT ordering.Key ResultsIn total, 385,375 FITs were ordered during this period with 116,727 representing participants returning following a previous negative FIT. In total, 35,148 (30.1%) returned early for screening. Men were more likely to return early than women (OR 1.14; 95% CI 1.11-1.17; p < 0.0001). Male physicians were more likely to order premature FITs (OR 1.15; 95% CI 1.06-1.24; p < 0.0001). A higher quantitative FIT value (ng/mL) of the previous FIT was also associated with early screening (OR 1.11; 95% CI 1.09-1.14; < 0.0001).ConclusionsThis study found that approximately 30% of FIT tests, ordered for CRC screening, were ordered before they were due. This may lead to wasted resources, unnecessary participant stress, and unwarranted patient risk.

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