Personalized Counseling May Overcome Non-Follow-Up After Positive FIT Test

Lack of knowledge, decision-making difficulties among factors identified with nonfollow-up.

HealthDay News Lack of knowledge and decision-making difficulties are associated with non-follow-up to positive fecal immunochemical test (FIT) results, according to a study published in the November/December issue of the Annals of Family Medicine.

Lucinda S. Bertels, Ph.D., from the University of Amsterdam, and colleagues surveyed 2,225 participants in the Dutch CRC screening program who received a positive FIT to understand factors associated with non-follow-up.

The researchers found that one-third of respondents reported no colonoscopy, with more than half (55 percent) reporting a contraindication. Non-follow-up was associated with decisional difficulties (odds ratio [OR], 0.29), lacking the opportunity to discuss the FIT outcome (OR, 0.45), and a low estimated risk for colorectal cancer (CRC; OR, 0.45). Having an alternative explanation for the positive FIT (OR, 0.3), having trust in the ability to self-detect CRC (OR, 0.42), and thinking that polyp removal is ineffective (OR, 0.59) were also negatively associated with follow-up. The strongest factor associated with follow-up was the belief that the family physician would support colonoscopy (OR, 2.84).

“Improving knowledge levels and offering personal guidance, possibly in the form of personalized screening counseling, as well as the involvement of family physicians, might prove beneficial for some FIT-positive individuals,” the authors write.

Abstract/Full Text