# Abnormal Fecal Test Results Associated with Colorectal Cancer Incidence and Mortality

> **NIH NIH R37** · VETERANS MEDICAL RESEARCH FDN/SAN DIEGO · 2020 · $77,357

## Abstract

PROJECT SUMMARY/ABSTRACT
Colorectal cancer (CRC) is the second most common cause of cancer-related mortality in the United States
(US). The US Preventive Services Task Force has instituted several modes of screening for early detection of
CRC, such as the fecal immunochemical test (FIT) and fecal occult blood tests (FOBT). FIT and FOBT are
common screening tool used in the US. FIT/FOBT must be followed by diagnostic colonoscopy when abnormal
to evaluate for precancerous and cancerous colorectal lesions. The literature is scarce and has varied results
on recommendations for how quickly to complete follow-up time. Studies suggesting an optimal window for
diagnostic follow-up vary their recommendations from 6 months to 24 months after abnormal FIT/FOBT.
Additionally, studies mainly came from international populations in Taiwan and Israel. Currently, there was only
one US study examining the effect of time to diagnostic colonoscopy and colorectal outcomes. This study only
looked at CRC incidence and stage of diagnosis, and not CRC mortality. Additionally, the study population was
limited to the state of California. Overall, the relationship between failure to complete diagnostic colonoscopy
after an abnormal FIT/FOBT on CRC outcomes has not been widely studied. Our study will use national
electronic health records and claims-based data from the Department of Veterans Affairs (VA) to address key
gaps in the literature by evaluating the relationship between diagnostic coloscopy and multiple CRC endpoints.
First, we will examine the risk for incident and fatal CRC cancer among individuals exposed versus unexposed
to diagnostic colonoscopy after abnormal FIT/FOBT (Aim 1). Next, we will determine the effect of time to
colonoscopy, among individuals exposed to diagnostic colonoscopy, on CRC incidence, stage at diagnosis,
and fatal cancer (Aim 2). Lastly, we will characterize the extent to which sociodemographic and clinical
variables (e.g. Charlson comorbidity, age, race) impact diagnostic completion after an abnormal FIT/FOBT
screening test (Aim 3).

## Key facts

- **NIH application ID:** 10063801
- **Project number:** 3R37CA222866-03S1
- **Recipient organization:** VETERANS MEDICAL RESEARCH FDN/SAN DIEGO
- **Principal Investigator:** Samir Gupta
- **Activity code:** R37 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $77,357
- **Award type:** 3
- **Project period:** 2018-02-01 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10063801

## Citation

> US National Institutes of Health, RePORTER application 10063801, Abnormal Fecal Test Results Associated with Colorectal Cancer Incidence and Mortality (3R37CA222866-03S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10063801. Licensed CC0.

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