Abstract
Background Late diagnosis of colorectal cancer (CRC) remains a public health challenge due to limitations in screening programs. This study evaluated the fecal immunochemical test (FIT) as an alternative screening method for CRC detection.Research design and methods Colonoscopy and immunochemical analysis were used as standard diagnostics. A population-based survey in Kazakhstan assessed disease prevalence and screening outcomes. Diagnostic accuracy and prognostic value of haemoccult testing were analyzed, comparing quantitative and qualitative results.Results Among 6,000 participants, 9.76% (n = 586) had positive FIT results. Elevated fecal hemoglobin concentrations (≥100 µg Hb/g stool) were found in 3.6% (n = 217), while 96.4% (n = 5786) had lower values. Of 150 clinically significant positive cases, 55 were confirmed, including 5 CRC cases and precancerous conditions. FIT facilitated large-scale screening. The Positive Predictive Value (PPV) for qualitative FIT was 10.4%, and for quantitative FIT (≥100 µg Hb/g), it was 15.7%. The Negative Predictive Value (NPV) for qualitative FIT was 100%, and for quantitative FIT, 99.5%. These results support FIT as a reliable, noninvasive tool for early CRC detection, particularly with proper triage.Conclusion FIT demonstrates practical value as an efficient screening tool for early CRC detection, with a weak but significant correlation to histological findings (p < 0.01).