Result card

  • SAF8: What is the safety of FIT in comparison to alternative technologies used for the same purpose?

What is the safety of FIT in comparison to alternative technologies used for the same purpose?

Authors: Agnes Männik, Irena Guzina, Petra Jandova, Leonor Varela Lema, Gerardo Atienza Merino

Internal reviewers: Matthias Schwenkglenks, Ingrid Wilbacher

The additional literature search was used.

The alternative technologies used for the same purpose are – colonoscopy (not specifically addressed here as covered elsewhere in the document), flexible sigmoidoscopy, computer tomography (CT) and barium enema. As all of the three techniques are invasive, non-invasive FIT and gFOBT tests are safer in terms of colonic perforation, ionizing radiation or sedation performed.

Levin, et al. (2002). Complications of screening flexible sigmoidoscopy {16}

Flexible sigmoidoscopy (FS) is an invasive diagnostic test and can cause perforation in the lining of the bowel, bleeding and infection. Sedation can cause problems with breathing, heart rate and blood pressure. The principal finding of this study was that the rate of complications after FS is modest. Approximately 1 in 5000 screening subjects was hospitalized for a gastrointestinal complication, and 1 in 16,000 was hospitalized for a serious complication. Colonic perforations, serious bleeding, and diverticulitis leading to surgery each occurred in this population less often than in 1 of 50,000 examinations.

Broadstock, (2007). Computed tomographic (CT) colonography for the detection of colorectal cancer – a Technical Brief {17}

Computer tomography has following disadvantages: patients are exposed to ionizing radiation, although low-radiation dose protocols are under investigation. False positives can occur as a result of retained stool in the bowel, diverticular disease (which can produce poorly distensible areas of the colon), or thickened bowel folds. Patients are associated with a very small risk of colonic perforation in CT colonograpy. Both, computer tomography and barium enema, were said to expose patients to ionizing radiation and to be associated with a very small risk of colonic perforation.

Männik A et al. Result Card SAF8 In: Männik A et al. Safety In: Jefferson T, Cerbo M, Vicari N [eds.]. Fecal Immunochemical Test (FIT ) versus guaiac-based fecal occult blood test (FOBT) for colorectal cancer screening [Core HTA], Agenas - Agenzia nazionale per i servizi sanitari regionali; 2014. [cited 3 December 2022]. Available from: