Gender Differences in Fecal Immunochemical Test Performance for Early Detection of Colorectal Neoplasia

Kapidzic, Atija; Meulen, Miriam P. van der; Hol, Lieke; Roon, Aafke H C van; Looman, Caspar W.N.; Lansdorp–Vogelaar, Iris; Ballegooijen, Marjolein van; Vuuren, Anneke J. van; Reijerink, Jacqueline C.; Leerdam, Monique E. van; Kuipers, Ernst J.

doi:10.1016/j.cgh.2015.02.023

Cited by 35 publications

(39 citation statements)

References 25 publications

(49 reference statements)

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“…Furthermore, we evaluated a wide range of cut-offs from a positivity threshold of ≥10 μ g/g (≥50 ng/mL). In comparison to previous studies using a ≥10 μ g/g cut-off [31, 36] (positivity rate: 8.4%–9.6%), our overall positivity rate was higher at 13.6%. This is potentially due to a higher prevalence of colorectal neoplasia in our population or variations in the FIT brand used, which has previously been shown to affect FIT performance [42], although this was not demonstrated in a recent meta-analysis [28].…”

Section: Discussioncontrasting

confidence: 95%

“…This is potentially due to a higher prevalence of colorectal neoplasia in our population or variations in the FIT brand used, which has previously been shown to affect FIT performance [42], although this was not demonstrated in a recent meta-analysis [28]. As anticipated, when comparing our PPV results for CRC and HRAs to previous studies [30, 31, 36, 37], the pattern of increasing PPV for CRC and HRAs with increasing FIT cut-off was reproduced. An unfortunate limitation of the literature is the variability in the definition of HRAs, which has hindered the feasibility for meta-analysis [28].…”

Section: Discussionmentioning

confidence: 46%

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Correlating Quantitative Fecal Immunochemical Test Results with Neoplastic Findings on Colonoscopy in a Population-Based Colorectal Cancer Screening Program: A Prospective Study

Shahidi

Gentile

Gondara

et al. 2016

Canadian Journal of Gastroenterology and Hepatology

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Background and Aims. The Canadian Partnership Against Cancer (CPAC) recommends a fecal immunochemical test- (FIT-) positive predictive value (PPV) for all adenomas of ≥50%. We sought to assess FIT performance among average-risk participants of the British Columbia Colon Screening Program (BCCSP). Methods. From Nov-2013 to Dec-2014 consecutive participants of the BCCSP were assessed. Data was obtained from a prospectively collected database. A single quantitative FIT (NS-Plus, Alfresa Pharma Corporation, Japan) with a cut-off of ≥10 μg/g (≥50 ng/mL) was used. Results. 20,322 FIT-positive participants underwent CSPY. At a FIT cut-off of ≥10 μg/g (≥50 ng/mL) the PPV for all adenomas was 52.0%. Increasing the FIT cut-off to ≥20 μg/g (≥100 ng/mL) would increase the PPV for colorectal cancer (CRC) by 1.5% and for high-risk adenomas (HRAs) by 6.5% at a cost of missing 13.6% of CRCs and 32.4% of HRAs. Conclusions. As the NS-Plus FIT cut-off rises, the PPV for CRC and HRAs increases but at the cost of missed lesions. A cut-off of ≥10 μg/g (≥50 ng/mL) produces a PPV for all adenomas exceeding national recommendations. Health authorities need to take into consideration endoscopic resources when selecting a FIT positivity threshold.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionmentioning

confidence: 46%

Correlating Quantitative Fecal Immunochemical Test Results with Neoplastic Findings on Colonoscopy in a Population-Based Colorectal Cancer Screening Program: A Prospective Study

Shahidi

Gentile

Gondara

et al. 2016

Canadian Journal of Gastroenterology and Hepatology

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“…Most of these programs use population-average thresholds of fecal hemoglobin concentration (f-Hb) to define test positivity (2, 3) while some adjustments have been made by the receiver operating characteristic (ROC) curve (4,5) or cost-effectiveness analyses (6,7). It should be noted that age-/sex-specific variations in the f-Hb have been shown in previous studies (8)(9)(10)(11)(12)). …”

Section: Introductionmentioning

confidence: 58%

Demand for Colonoscopy in Colorectal Cancer Screening Using a Quantitative Fecal Immunochemical Test and Age/Sex-Specific Thresholds for Test Positivity

Chen

Hsu

Yen

et al. 2018

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…Two other studies likewise found a higher sensitivity of FIT for advanced neoplasia in men compared with women (6,7), and also a higher positive predictive value (PPV), whereas FIT specificity in men was found to be significantly lower (6). The lower specificity in men was confirmed in the FIT screening trial CORERO-1 with a higher FPR in men compared with women (8).…”

Section: Introductionmentioning

confidence: 82%

“…The PPV for advanced neoplasia did not differ significantly for men (42.1%) and women (37.0%; P ¼ 0.265). Positivity rates, detection rates, and the PPV at higher cutoffs can be found elsewhere (8).…”

Section: The Corero Trialmentioning

confidence: 99%

Do Men and Women Need to Be Screened Differently with Fecal Immunochemical Testing? A Cost-Effectiveness Analysis

Meulen

Kapidzic

Leerdam

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Several studies suggest that test characteristics for the fecal immunochemical test (FIT) differ by gender, triggering a debate on whether men and women should be screened differently. We used the microsimulation model MISCAN-Colon to evaluate whether screening stratified by gender is cost-effective. We estimated gender-specific FIT characteristics based on first-round positivity and detection rates observed in a FIT screening pilot (CORERO-1). Subsequently, we used the model to estimate harms, benefits, and costs of 480 gender-specific FIT screening strategies and compared them with uniform screening. Biennial FIT screening from ages 50 to 75 was less effective in women than men [35.7 vs. 49.0 quality-adjusted life years (QALY) gained, respectively] at higher costs (€42,161 vs. -€5,471, respectively). However, the incremental QALYs gained and costs of annual screening compared with biennial screening were more similar for both genders (8.7 QALYs gained and €26,394 for women vs. 6.7 QALYs gained and €20,863 for men). Considering all evaluated screening strategies, optimal gender-based screening yielded at most 7% more QALYs gained than optimal uniform screening and even resulted in equal costs and QALYs gained from a willingness-to-pay threshold of €1,300. FIT screening is less effective in women, but the incremental cost-effectiveness is similar in men and women. Consequently, screening stratified by gender is not more cost-effective than uniform FIT screening. Our conclusions support the current policy of uniform FIT screening. .

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Gender Differences in Fecal Immunochemical Test Performance for Early Detection of Colorectal Neoplasia

Cited by 35 publications

References 25 publications

Correlating Quantitative Fecal Immunochemical Test Results with Neoplastic Findings on Colonoscopy in a Population-Based Colorectal Cancer Screening Program: A Prospective Study

Correlating Quantitative Fecal Immunochemical Test Results with Neoplastic Findings on Colonoscopy in a Population-Based Colorectal Cancer Screening Program: A Prospective Study

Demand for Colonoscopy in Colorectal Cancer Screening Using a Quantitative Fecal Immunochemical Test and Age/Sex-Specific Thresholds for Test Positivity

Do Men and Women Need to Be Screened Differently with Fecal Immunochemical Testing? A Cost-Effectiveness Analysis

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