In October 2024, a national screening program for colorectal cancer using the fecalimmunochemical test (FIT) for hemoglobin detection in stool was implemented for the firsttime in Greece. The aim of the present study is to describe colonoscopy findings inindividuals with a positive FIT test.

This is a retrospective observational study including patients aged 50–70 years in the Atticaregion who were referred for colonoscopy due to a positive FIT test. Patients werecategorized based on prior endoscopic evaluation, and colonoscopy findings were recorded:adenomas, advanced adenomas (size ≥10 mm), and cancer.

A total of 140 patients were included. Of these, 96 (68.6%) had never undergonecolonoscopy, 11 (7.9%) had been examined more than 10 years earlier, and 2 (1.4%) had ahistory of incomplete endoscopy. Adenomas were detected in 73 patients (52.1%), of whom37 (26.4%) had advanced features. Of the advanced adenomas, 30 (81.1%) were located inthe left colon. Among the 41 patients with advanced adenomas or cancer, one (2.4%) hadundergone a recent prior colonoscopy (3 years earlier), representing an interval advancedadenoma. Colorectal cancer was diagnosed in 4 patients (2.8%), all stage I according to theTNM classification.

The implementation of the FIT test within the national screening program appears tosuccessfully target a population without prior adequate endoscopic evaluation and achievesneoplasia detection rates comparable to international reports. The high proportion of early-stage detections supports the importance of expanding and establishing the program at anational level.