An organized fecal immunochemical testing (FIT)-based colorectal cancer screening program is associated with lower cancer mortality, according to a study published Aug. 5 in JAMA Network Open. Researchers led by Luis Bujanda of the University of the Basque Country evaluated the program's effect in Spain's Basque Country, a region of approximately 2.2 million inhabitants.
The biennial screening program began in 2009, targeting residents ages 50–69. Between 2004 and 2024, age-standardized colorectal cancer mortality fell from 32.8 deaths per 100,000 population to 23.1 deaths per 100,000, a decline of 29.6%. Among those in the screening age group, mortality fell from 39.7 to 19.8 deaths per 100,000, a reduction of 50.1%.
A significant shift in the mortality trend occurred in 2012, three years after screening began. Among people ages 50–69, the researchers estimated that screening accounted for a 46.2% relative reduction in colorectal cancer mortality compared with projected trends without the program. Among those 70 and older, colorectal cancer mortality declined 45.4% relative to projected rates, falling from 165.4 to 132.9 deaths per 100,000 population.
Of the 4,892 colorectal cancers detected through screening, 70.8% were diagnosed at stage I or II, earlier stages when treatment is typically more effective. The authors noted that the findings "support the long-term benefit of organized FIT-based screening programs as a public health strategy to reduce CRC-related mortality."
