title: The fecal immunochemical test has high accuracy for detecting advanced colorectal neoplasia before age 50.
abstract: BACKGROUND
  In contrast to the decreasing incidence of colorectal cancer (CRC) in adults ≥50 years, the CRC incidence in young adults <50 years is increasing. The fecal immunochemical test (FIT) may be useful for advanced colorectal neoplasia (ACRN) screening in a young population.
  
  
  OBJECTIVE
  To evaluate the diagnostic accuracy of FIT in a young population.
  
  
  METHODS
  The diagnostic performance of FIT for detecting ACRN was compared among the following age groups who underwent FIT and colonoscopy as part of a comprehensive health screening program: 30-39, 40-49, and ≥50 years.
  
  
  RESULTS
  Of 26,316 participants, 464 (1.8%) had ACRN and 805 (3.1%) showed positive FIT results. No significant differences in the sensitivity (22.1%, 17.2%, and 22.0%; p=0.435) and specificity (97.2%, 97.4%, and 96.9%; p=0.344) of FIT for detecting ACRN were observed among the groups. However, 30-39 age group had a significantly higher accuracy of FIT for ACRN (96.7%) than 40-49 and ≥50 age groups (95.9% and 93.8%; p<0.001). The areas under the receiver operating characteristic curves of FIT for ACRN of three age groups were not significantly different (67.2, 66.2, and 61.7; p=0.952).
  
  
  CONCLUSIONS
  The diagnostic performance of FIT for ACRN in a young population (<50 years) was not inferior to that in the current screening-age population (≥50 years). The FIT may be a good choice for detecting ACRN in a young population.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Nam Hee
authors.initials: NH
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Chong Il
authors.initials: CI
authors.lastname: Sohn
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kyuyong
authors.initials: K
authors.lastname: Choi
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: ys810.jung@samsung.com.
authors.forename: Yoon Suk
authors.initials: YS
authors.lastname: Jung
mesh_terms: D000328:Adult; D017677:Age Distribution; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006454:Hemoglobins / Q000737:chemistry / Q000276:immunology*; D006801:Humans; D007159:Immunologic Tests; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D056910:Republic of Korea / Q000453:epidemiology
chemical_list: D006454:Hemoglobins
keywords: Advanced colorectal neoplasia; Fecal immunochemical test; Young population