Colonoscopy Versus Fecal Immunochemical Test for Reducing Colorectal Cancer Risk: A Population-Based Case-Control Study

Su Young Kim, Hyun Soo Kim, Yun Tae Kim, Jung Kuk Lee, Hong Jun Park, Hee Man Kim, Dae Ryoung Kang

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


INTRODUCTION:Use of colonoscopy or the fecal immunochemical test (FIT) for colorectal cancer (CRC) prevention is supported by previous studies. However, there is little specific evidence regarding comparative effectiveness of colonoscopy or FIT for reducing CRC risk. In this study, we compared the association of CRC risk with colonoscopy and FIT using a nationwide database.METHODS:This population-based case-control study used colonoscopy and FIT claims data from the Korean National Health Insurance System from 2002 to 2013. Data were analyzed from 61,221 patients with newly diagnosed CRC (case group) and 306,099 individuals without CRC (control group). Multivariable logistic regression models were used to evaluate the association between CRC and colonoscopy or FIT.RESULTS:Colonoscopy was associated with a reduced subsequent CRC risk (adjusted odds ratio [OR] 0.29). Stronger associations were found between colonoscopy and distal CRC, compared with proximal CRC (0.24 vs 0.47). In an analysis stratified by sex, the association was weaker in female subjects compared with male subjects (0.33 vs 0.27). Any FIT exposure was associated with CRC risk with an OR of 0.74; this association was stronger for distal cancer. As the frequency of cumulative FIT assessments increased (from 1 to ≥5), the OR of FIT exposure for CRC gradually decreased from 0.81 to 0.45.DISCUSSION:The association of colonoscopy or FIT with reduced CRC risk was stronger for distal CRC than for proximal CRC. FIT showed less CRC risk reduction than colonoscopy. However, as the frequency of cumulative FIT assessments increased, the association with CRC prevention became stronger.

Original languageEnglish
Pages (from-to)E00350
JournalClinical and translational gastroenterology
Issue number5
Publication statusPublished - 2021 May 30

Bibliographical note

Funding Information:
Financial support: This work was supported by grants from the National Research Foundation of Korea (2019R1A2C1007859), Ministry of Science and ICT, the National R&D Program for Cancer Control (HA17C0046), and the Korean National Health Clinical Research (NHCR) project (HC16C2320), Ministry of Health & Welfare, Republic of Korea. This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (grant number: 2020R1I1A306686511).

Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Gastroenterology


Dive into the research topics of 'Colonoscopy Versus Fecal Immunochemical Test for Reducing Colorectal Cancer Risk: A Population-Based Case-Control Study'. Together they form a unique fingerprint.

Cite this