FIT-Positive Patients Have Higher Rates of Colorectal Cancer and Advanced Neoplasia Compared to Screening Colonoscopy Patients: 272

Introduction: The Fecal Immunochemical Test (FIT) screens for colorectal cancer (CRC), but its efficacy for detecting both precancerous and cancerous lesions has not been completely investigated. We compared colonoscopy outcomes in FIT positive patients to screening colonoscopy patients on malignancy, advanced adenomas, precancerous polyps, and sessile serrated adenomas at a Veterans Affairs Medical Center (VAMC). Methods: Colonoscopy findings of FIT positive patients (n=154) and screening colonoscopy patients (n=96) were gathered from 2012 to 2015 at the VAMC. Presence and location of CRC, advanced adenomas (adenomas \u3e10mm, tubulovillous or villous histology, or presence of high grade dysplasia), nonadvanced adenomas, and sessile serrated adenomas (SSA) were collected. Statistical analysis included chi square and Mann-Whitney tests Results:Fifteen of 154 (9.7%) FIT positive patients had CRC compared to 1 of 96 (1.0%) for screening colonoscopypatients (p=0.006). FIT positive patients were more likely to have advanced adenomas (31% vs. 8%, p Conclusion: FIT positive patients had higher rates of colorectal cancer, advanced adenomas, and precancerous polyps compared to the screening colonoscopy group. These findings refute studies showing similar rates ofneoplasia between the two groups, but support FIT’s limited role for detecting SSA. With advanced adenomas being synonomous with impending colorectal cancer, our findings might influence decision-making prior to performing colonoscopy on FIT positive patients, as the probability of finding an advanced adenoma and CRC is higher