While screening by Fecal Immunochemical Test (FIT) can detect colon cancer early, successful treatment depends on if the patient will do a follow up colonoscopy after an unfavorable test result.

A paper published by Dutch researchers examines the reasons why some people do not follow up after a positive at-home test. The researchers argue that understanding the reasons people don’t follow up with their doctors has global implications for all people at risk of the cancer as it is best treated early.

Reasons for lack of follow-up include concerns about having a colonoscopy; lack of opportunity to discuss next steps with a medical provider; assumptions and perceptions about their personal risk; a belief that the test result is not indicative of cancer; and questioned effectiveness of polyp removal, as well as poor overall health behaviors.

The strongest positive association with follow-up was the patient’s belief that their family physician would support colonoscopy, as well as fear of cancer. Researchers suggest that personalized screening counseling may help, as well as the involvement of family practitioners.

For the study, the researchers distributed a nationwide cross-sectional questionnaire to participants in the Dutch CRC screening program who received a positive fecal immunochemical test (FIT). Among respondents who reported no colonoscopy, the researchers assessed the presence of a contraindication, and those without were compared with those who reported colonoscopy by logistic regression analysis.

Featured image: Reasons for no colonoscopy after an unfavorable screening result in Dutch colon cancer screening: a nation-wise questionnaire. Photo: The Annals of Family Medicine