Current Status of External Quality Assessment of Fecal Occult Blood Test

Yoo, Soo Jin; Joο, Young Eun; Min, Won‐Ki; Lee, You Kyoung; Chae, Seok-Lae; Shin, Bo-Moon; Lim, Hwan Sub

doi:10.3343/kjlm.2010.30.6.726

Cited by 2 publications

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References 4 publications

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“…Since 2007, KSLM has conducted an external quality assessment of FITs, using external quality assessment materials. A total of 650 general hospitals and hospitals participated in the external quality assessment of KSLM between 2007 and 2009, and the number of participating facilities has not increased [ 6 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although the participation rate for colorectal cancer screening has rapidly increased with the number of cancer screening facilities, issues with the quality assurance of these facilities have been noted [ 4 ]. Since 2008, Korean Society of Laboratory Medicine (KSLM), Korean Society of Gastrointestinal Endoscopy (KSGE), and the National Cancer Center of Korea have implemented the National Quality Improvement Program for colorectal cancer screening to evaluate facilities participating in the NCSP, with the goal of improving the quality of colorectal cancer screening [ 5 6 7 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Budget Impact of the Accreditation Program for Clinical Laboratories on Colorectal Cancer Screening via Fecal Immunochemical Testing: Results from the National Cancer Screening Program in Korea

et al. 2018

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BackgroundFalse-positive fecal immunochemical test (FIT) results in the National Cancer Screening Program (NCSP) for colorectal cancer may lead to unnecessary procedures, such as colonoscopies, increasing the medical costs. We estimated reductions in the cost of National Health Insurance according to the accreditation status of screening facilities participating in the NCSP for colorectal cancer.MethodsWe used data collected between 2007 and 2010 from NCSP and the Korea Central Cancer Registry to identify patients with colorectal cancer. We also ascertained the history of the accreditation of each facility by the Korean Laboratory Accreditation Program (KLAP). Budget impact was defined as a reduction in medical costs achieved when the false-positive rate of the non-accredited facilities decreased relative to that of the accredited facilities.ResultsA total of 3,285 screening facilities participated in the NCSP. Of these, 196 were accredited by the KLAP. The false-positive rate of the accredited facilities was 2.47%, and that of the non-accredited facilities was 6.83%. Medical costs were estimated to be reduced by approximately 19 million US dollars (USD), and the cost of detecting one case of colorectal cancer was estimated to decrease from 9,212 USD to 7,332 USD if the false-positive rate of non-accredited facilities were decreased to that of the accredited facilities. Clinics were estimated to have the largest associated cost reduction.ConclusionsQuality assurance in clinical laboratories could lower false-positive rates and prevent the use of unnecessary procedures, ensuring patient safety and increasing the cost-effectiveness of FIT screening in the NCSP for colorectal cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Budget Impact of the Accreditation Program for Clinical Laboratories on Colorectal Cancer Screening via Fecal Immunochemical Testing: Results from the National Cancer Screening Program in Korea

et al. 2018

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Evaluation of the Cut-Off Value of Fecal Immunochemical Test for Colorectal Cancer Screening during Health Checkups

Park

Nah

Lee

et al. 2021

J Lab Med Qual Assur

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Background:The fecal immunochemical test (FIT) is recommended as the first choice for mass colorectal cancer (CRC) screening in the community. The cut-off value can be adjusted according to the target population and colonoscopy resources. We aimed to compare and determine the optimal cut-off value for CRC screening to strike a balance between FIT performance and colonoscopy burden. Methods: This cross-sectional retrospective study consecutively selected subjects who underwent health checkups including FIT and colonoscopy at 16 health-promotion centers in Korea between 2018 and 2019. FIT was performed using an OC-SENSOR PLEDIA (Eiken Chemical Co., Japan). We assessed the test performance in detecting CRC and measured the burden of colonoscopy with different cut-off values of 22 (FIT 22) ng/mL, 50 (FIT 50) ng/mL, and 100 (FIT 100) ng/mL. Results: Among the 90,323 participants, CRC was found in 485 patients (0.54%). From FIT 22 and, FIT 50 to FIT 100, the positivity rate decreased from 4.7% and, 3.6% to 3.1%, and AUC were 0.79, 0.77, and 0.76, respectively. The sensitivity/specificity of FIT 22, FIT 50, and FIT 100 for CRC were 61.9%/95.6%, 57.3%/96.7%, and 54.0%/97.1%, respectively, and their positive predictive value/negative predictive value were 7.0%/99.8%, 8.7%/99.8%, and 9.3%/99.8%, respectively. The number of colonoscopies needed to detect one CRC for FIT 22, FIT 50, and FIT 100 were 14.3, 11.6, and 10.8, respectively. Conclusions: This study presents cut-off values for CRC screening to strike a balance between FIT performance and colonoscopy burden, which could provide information for the cut-off of FIT for CRC in a national cancer screening program.

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Current Status of External Quality Assessment of Fecal Occult Blood Test

Cited by 2 publications

References 4 publications

Budget Impact of the Accreditation Program for Clinical Laboratories on Colorectal Cancer Screening via Fecal Immunochemical Testing: Results from the National Cancer Screening Program in Korea

Budget Impact of the Accreditation Program for Clinical Laboratories on Colorectal Cancer Screening via Fecal Immunochemical Testing: Results from the National Cancer Screening Program in Korea

Evaluation of the Cut-Off Value of Fecal Immunochemical Test for Colorectal Cancer Screening during Health Checkups

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