Evaluation of the Accuracy of Fecal Immunochemical Testing for Colorectal Cancer Screening in an Average-Risk Population: A Prospective Study

Background: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Early detection through screening improves survival rates, particularly in average-risk populations. Fecal Immunochemical Testing (FIT) offers a non-invasive, cost-effective screening method that has gained widespread acceptance.Objective: To evaluate the accuracy of FIT for CRC screening in an average-risk population.Methods: This prospective observational study was conducted at Khyber Teaching Hospital, Peshawar, from January 2023 to December 2023. A total of 185 patients aged ≥18 years with average CRC risk were included. FIT was used to detect occult blood, and all participants underwent colonoscopy as the reference standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, with data analysis performed using SPSS version 25.Results: FIT demonstrated a sensitivity of 87.5%, specificity of 86.0%, PPV of 23.3%, and NPV of 99.0%. Among 185 patients, 3.8% had CRC, 8.1% had advanced adenomas, and 4.3% were false positives. One patient (0.5%) had a false negative result.Conclusion: FIT is a highly effective and reliable screening tool for detecting CRC and advanced adenomas in average-risk populations, though follow-up colonoscopy is essential for positive results.