Incidence and outcomes of interval colorectal cancer in a fecal immunochemical test-based screening program

Interval colorectal cancer (CRC) can occur after a negative test result of a primary screening test or after colonoscopy for a positive screening test result without the diagnosis of CRC. A retrospective cohort study among participants of the FIT-based Taiwan CRC Screening Program investigated incidence and outcomes of interval CRC. In this study of 4018 patients with interval CRCs, interval CRC incidence and mortality were higher after follow-up colonoscopy than after negative FIT result. Hospital-level adenoma detection rate (ADR) was inversely associated with postcolonoscopy interval CRC incidence. However, among patients with postcolonoscopy interval CRC, CRC-specific death was higher in the high-ADR versus low ADR setting, suggesting a ceiling effect for current colonoscopic techniques and highlighting a possible interplay between procedural and biological factors.