Attendance and diagnostic yield of repeated two-sample faecal immunochemical test screening for colorectal cancer

Kapidzic, Atija; Roon, Aafke H C van; Leerdam, Monique E. van; Ballegooijen, Marjolein van; Lansdorp–Vogelaar, Iris; Spijker, Wolfert; Izelaar, Kirsten; Hol, Lieke; Kuipers, Ernst J.

doi:10.1136/gutjnl-2014-308957

Cited by 30 publications

(23 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Given these advantages, FITs are meanwhile a broadly recommended option for CRC screening, e.g., 11 , 12 and FIT-based CRC screening has recently been introduced or is currently being introduced or expanded in a number of countries. 13 However, a number of features of FIT testing are subject to ongoing debate, such as the number of feces samples to be tested, 5 , 14 the best cut-off for positivity 5 , 15 or the time intervals for FIT-based screening. 16 , 17 For example, in the Netherlands, a cut-off of 10 μg Hb per gram (g) feces was used in the pilot studies for FIT-based screening.…”

Section: Introductionmentioning

confidence: 99%

“… 16 , 17 For example, in the Netherlands, a cut-off of 10 μg Hb per gram (g) feces was used in the pilot studies for FIT-based screening. 14 The screening program initiated in 2014 started with a cut-off at 15 μg Hb/g feces which was later increased to 47 μg Hb/g feces due to higher than predicted numbers of positive results. 18 In the United States, a cut-off of 20 μg Hb/g feces is commonly used.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Selecting a Cut-off for Colorectal Cancer Screening With a Fecal Immunochemical Test

Brenner¹,

Werner

2017

Clinical and Translational Gastroenterology

View full text Add to dashboard Cite

Objectives:Fecal immunochemical tests (FITs) for hemoglobin (Hb) are increasingly used for colorectal cancer (CRC) screening. However, cut-offs for defining test positivity are varying widely. We aimed to evaluate the impact of cut-off selection on key indicators of diagnostic performance in a true screening setting.Methods:We evaluated diagnostic performance of FOB Gold, a widely used quantitative FIT, for detecting advanced neoplasms (AN) across a wide range of possible cut-offs among 1822 participants of screening colonoscopy aged 50–79 years in Germany.Results:The positive predictive value (PPV) for detecting AN showed a very steep increase with increasing cut-off up to 35.2% (95% CI 29.9–40.9%) at a cut-off of 9 μg Hb/g feces at which sensitivity and specificity were 48.8% (95% CI 42.1–55.6%) and 88.5% (95% CI 86.8–89.9%), respectively. A further moderate increase of PPV up to 56.9% (95% CI 47.8–65.5%), along with a major decrease in sensitivity was observed when gradually increasing the cut-off to 25 μg Hb/g feces at which sensitivity and specificity were 31.9% (95% CI 25.9–38.5%) and 96.9% (95% CI 95.9–97.6%), respectively. Further increases of the cut-off hardly affected PPV and specificity, but went along with further relevant decline in sensitivity.Conclusions:Our study illustrates delineation of a range of meaningful cut-offs (here: 9–25 μg Hb/g feces) according to expected diagnostic yield in a true screening setting. Selecting a cut-off within or beyond this range should consider characteristics of the specific target population, such as AN prevalence or available colonoscopy capacity.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Selecting a Cut-off for Colorectal Cancer Screening With a Fecal Immunochemical Test

Brenner¹,

Werner

2017

Clinical and Translational Gastroenterology

View full text Add to dashboard Cite

show abstract

“…Previous studies comparing FIT brands in CRC screening studied either randomized subjects to perform a single FIT, 13,[15][16][17] or had FITs performed in different bowel movements. 30 Differences in true-positive rate in favor of OC-Sensor to FOB-Gold were found in a Spanish screening cohort in which participants were randomly invited to perform one of both tests. 15 The cutoff was equalized in ng Hb/mL buffer, instead of mg Hb/g feces, therefore, subject to known differences in buffer volumes between both FIT brands (1.7 mL FOB-Gold and 2.0 mL OC-Sensor).…”

Section: Discussionmentioning

confidence: 99%

Equivalent Accuracy of 2 Quantitative Fecal Immunochemical Tests in Detecting Advanced Neoplasia in an Organized Colorectal Cancer Screening Program

Wieten

Klerk

Steen³

et al. 2018

Gastroenterology

Self Cite

View full text Add to dashboard Cite

“…An OC-Sensor test with a cut-off concentration of 20 µg Hb/g feces buffer was defined as positive, as determined by the Health Promotion Administration [ 8 ]. Because some institutions use a cut-off value of 10 µg Hb/g feces for CRC screening, we defined the borderline range as 10.2–20 µg Hb/g feces [ 9 10 ].…”

mentioning

confidence: 99%

Is It Necessary to Repeat Fecal Occult Blood Tests with Borderline Results for Colorectal Cancer Screening?

Lee

2018

Ann Lab Med

View full text Add to dashboard Cite

The fecal immunochemical test (FIT) is the initial non-invasive investigation of choice for population-based colorectal cancer (CRC) screening. We evaluated the positivity rate in repeated tests using the same fecal specimen that showed borderline results in the FIT. A total of 6,465 patients were tested with the FIT in a tertiary-care hospital from July to December 2016. FIT was done using OC-Sensor PLEDIA (Eiken Chemical Co., Tokyo, Japan). Among 6,465 patients, 364 (5.6%) patients showed a positive FIT result of over 20 µg Hb/g feces. A total of 112 (1.7%) patients showed borderline scores of 10.2–20 µg Hb/g feces, and 5,989 (92.6%) patients showed negative results of less than 10 µg Hb/g feces. Among the 101 repeat-tested patients, 19 (18.8%) of the patients' scores converted to levels above the positive cut-off threshold. Repeated results of 19 patients showed score elevations from 20.2 to 68 µg Hb/g feces. These results suggest that it is most important to analyze properly prepared samples, even if only once. Therefore, the laboratory staff should ensure the proper preparation of stool specimens for FIT. Laboratory directors should choose the best cut-off value for detecting CRC at their respective institutions.

show abstract

Attendance and diagnostic yield of repeated two-sample faecal immunochemical test screening for colorectal cancer

Cited by 30 publications

References 14 publications

Selecting a Cut-off for Colorectal Cancer Screening With a Fecal Immunochemical Test

Selecting a Cut-off for Colorectal Cancer Screening With a Fecal Immunochemical Test

Equivalent Accuracy of 2 Quantitative Fecal Immunochemical Tests in Detecting Advanced Neoplasia in an Organized Colorectal Cancer Screening Program

Is It Necessary to Repeat Fecal Occult Blood Tests with Borderline Results for Colorectal Cancer Screening?

Contact Info

Product

Resources

About