Immunochemical Fecal Occult Blood Testing Is Equally Sensitive for Proximal and Distal Advanced Neoplasia

Wijkerslooth, Thomas R. de; Stoop, Esther M.; Bossuyt, Patrick M.; Meijer, Gerrit A.; Ballegooijen, Marjolein van; Roon, Aafke H C van; Stegeman, Inge; Kraaijenhagen, Roderik A.; Fockens, Paul; Leerdam, Monique E. van; Dekker, Evelien; Kuipers, Ernst J.

doi:10.1038/ajg.2012.249

Cited by 174 publications

(178 citation statements)

References 37 publications

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“…The early stage of development of our test does not yet allow a full comparison with existing screening methods. Nevertheless, it is of interest to note that the adenoma detection rate (46%) was superior to the ones reported for faecal immunochemical testing (FIT, 20%-29%), 35,36 or…”

Section: Discussionmentioning

confidence: 99%

A novel gene expression signature in peripheral blood mononuclear cells for early detection of colorectal cancer

Nichita

Ciarloni

Monnier-Benoit³

et al. 2014

Aliment Pharmacol Ther

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These authors are regarded as joint first authors, having contributed equally to the manuscript. SUMMARY BackgroundEarly detection and treatment of colorectal adenomatous polyps (AP) and colorectal cancer (CRC) is associated with decreased mortality for CRC. However, accurate, non-invasive and compliant tests to screen for AP and early stages of CRC are not yet available. A blood-based screening test is highly attractive due to limited invasiveness and high acceptance rate among patients.

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Section: Discussionmentioning

confidence: 99%

A novel gene expression signature in peripheral blood mononuclear cells for early detection of colorectal cancer

Nichita

Ciarloni

Monnier-Benoit³

et al. 2014

Aliment Pharmacol Ther

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confidence: 99%

“…Given its considerable false negative rate in the detection of advanced neoplasia, FIT should be applied at regular intervals for an optimal preventive effect. 3 With a specificity of 94% at the 50 ng/ml cut off, the accuracy of FIT based screening is suboptimal. 3 A false positive test result will lead to unnecessary colonoscopies, accompanied by extra costs, burden and risks for the patient, which could affect participation in screening programs.…”

mentioning

confidence: 99%

Risk factors for false positive and for false negative test results in screening with fecal occult blood testing

Stegeman

Wijkerslooth

Stoop

et al. 2013

Intl Journal of Cancer

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Differences in the risk of a false negative or a false positive fecal immunochemical test (FIT) across subgroups may affect optimal screening strategies. We evaluate whether subgroups are at increased risk of a false positive or a false negative FIT result, whether such variability in risk is related to differences in FIT sensitivity and specificity or to differences in prior CRC risk. Randomly selected, asymptomatic individuals were invited to undergo colonoscopy. Participants were asked to undergo one sample FIT and to complete a risk questionnaire. We identified patient characteristics associated with a false negative and false positive FIT results using logistic regression. We focused on statistically significant differences as well as on variables influencing the false positive or negative risk for which the odds ratio exceeded 1.25. Of the 1,426 screening participants, 1,112 (78%) completed FIT and the questionnaire; 101 (9.1%) had advanced neoplasia. 102 Individuals were FIT positive, 65 (64%) had a false negative FIT result and 66 (65%) a false positive FIT result. Participants at higher age and smokers had a significantly higher risk of a false negative FIT result. Males were at increased risk of a false positive result, so were smokers and regular NSAID users. FIT sensitivity was lower in females. Specificity was lower for males, smokers and regular NSAID users. FIT sensitivity was lower in women. FIT specificity was lower in males, smokers and regular NSAID users. Our results can be used for further evidence based individualization of screening strategies.Colorectal cancer (CRC) is one of the leading causes of cancer related death. 1 Detecting cancer or one of its precursors at an early stage can prevent premature death and may reduce cancer morbidity, since treatment for earlier-stage cancers is less aggressive than that for more advanced stage cancers. 2 The high incidence of CRC, the high burden of disease, the availability of screening tests and of effective treatment of adenomas make CRC a likely candidate for population screening.Colonoscopy is the reference standard for the detection of advanced adenoma and cancer in CRC screening. As it is a burdensome and costly procedure, fecal immunochemical test (FIT) is often used as a noninvasive triaging test for colonoscopy in CRC screening programs. Given its considerable false negative rate in the detection of advanced neoplasia, FIT should be applied at regular intervals for an optimal preventive effect. 3 With a specificity of 94% at the 50 ng/ml cut off, the accuracy of FIT based screening is suboptimal. 3 A

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“…Nonetheless the results were statistically insignificant, 26 and were contradictory to another Dutch trial. 27 The positivity rate of iFOBT ranges from 5.5% to 11.0%. 12,13,17,19,28,29 The sensitivity and specificity for CRC ranges from 53.3% to 94.1% and 87.5% to 96.9%, respectively.…”

Section: Immunochemical Faecal Occult Blood Testingmentioning

confidence: 99%

Alternatives to colonoscopy for population-wide colorectal cancer screening

Leung¹,

Foo²,

Chan³

et al. 2016

Hong Kong Med J

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Immunochemical Fecal Occult Blood Testing Is Equally Sensitive for Proximal and Distal Advanced Neoplasia

Abstract: Nine out of ten screening participants with CRC and four out of ten with advanced neoplasia will be detected using one single FIT at low cutoff. Sensitivity in detecting proximal and distal advanced neoplasia is comparable.

Cited by 174 publications

References 37 publications

A novel gene expression signature in peripheral blood mononuclear cells for early detection of colorectal cancer

A novel gene expression signature in peripheral blood mononuclear cells for early detection of colorectal cancer

Risk factors for false positive and for false negative test results in screening with fecal occult blood testing

Alternatives to colonoscopy for population-wide colorectal cancer screening

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