FIT-Based Colorectal Cancer Screening Significantly Reduces Mortality: Study

A new study published in the Journal of American Medical Association showed that an organized fecal immunochemical test (FIT) screening program was linked to a decrease in colorectal cancer (CRC) mortality, particularly among people aged 50 to 69 years.

Colorectal cancer is the largest cause of cancer-related deaths globally. FIT is a stool test that identifies concealed blood, which may indicate colon cancer or precancerous growths. Organized screening programs try to detect cancer earlier and identify advanced adenomas that can be removed before they develop into malignancy. Thus, the goal of this study was to determine if biannual FIT-based screening was related to a decreased CRC mortality.

This retrospective cohort research includes 2.2 million Basque Country inhabitants between 2004 and 2024. The coordinated FIT-based screening program began in 2009 and aimed at individuals aged 50 to 69 years. This study evaluated CRC-specific and all-cause death trends before and after program implementation, as well as trends among those under the age of 50. Mortality trends were assessed using segmented regression and counterfactual analyzes.

In a population of about 2.2 million, CRC was responsible for 16 298 (3.7%) of the 438 134 overall fatalities (50.9% in males). Between 2004 and 2024, age-standardized CRC mortality decreased from 32.8 to 23.1 deaths per 100,000 people. CRC mortality decreased by 50.1% among those between the ages of 50 and 69 (from 39.7 to 19.8 deaths per 100,000 population).

3 years after screening was implemented, in 2012 (95% CI, 2011-2014; P <.001), segmented regression revealed a major turning point. When compared to predicted trends without screening, counterfactual analyzes revealed a 46.2% relative decrease in CRC mortality in the 50–69 age range. CRC mortality decreased by 19.6% (from 165.4 to 132.9 deaths per 100,000 population) among those 70 years of age or older.

This is a 45.4% relative decrease when compared to anticipated rates. During the course of the trial, 3464 out of 4892 screen-detected CRCs (70.8%) had a stage I or II diagnosis. Overall, adults between the ages of 50 and 69 benefited from a coordinated biannual FIT-based colorectal cancer screening program, which was linked to a significant decrease in CRC mortality. The results validate the usefulness of stool testing as a tactic to lower colorectal cancer mortality.

Source:

Bujanda, L., Val, B., Portillo Villares, I., Idigoras-Rubio, I., Banales, J. M., Gutierrez-Stampa, M. A., Lopez de Munain, A., Audicana, C., Calleja, O., Cubiella, J., & Izquierdo-Sanchez, L. (2026). Colorectal cancer mortality following an organized fecal immunochemical test-based screening program. JAMA Network Open, 9(8), e2626951. https://doi.org/10.1001/jamanetworkopen.2026.26951