Single and double fecal immunochemical tests (FIT) effectively identify colorectal cancer risk in patients with rectal bleeding, crucial for surgical decisions.

• FIT positivity is significantly higher in patients with rectal bleeding (34.7%) than those without (18.6%).
• Sensitivity for detecting colorectal cancer is 98.0% in patients with rectal bleeding compared to 82.5% in those without.

Patients with rectal bleeding and two negative FIT results have virtually no risk of colorectal cancer, improving screening strategies.

• Double FITs boost sensitivity to 100% in rectal bleeding cases, matching the non-bleeding group’s performance.