Physician‐office vs home uptake of colorectal cancer screening using FOBT/FIT among screening‐eligible US adults

Abstract

Background Guidelines of the American Cancer Society and US Preventive Services Task Force specify that colorectal cancer (CRC) screening using guaiac‐based fecal occult blood test (FOBT)/fecal immunochemical test (FIT) should be done at home. We therefore examined the prevalence and correlates of CRC screening using FOBT/FIT in physicians' office vs at home. Methods Analysis of 9493 respondents 50‐75 years old from the Cancer Control Supplement of the 2015 National Health Interview Survey was conducted. Weighted multivariable logistic regression was used to identify the determinants of in‐office vs home use of FOBT/FIT for CRC screening. Results Of the overall sample of screening‐eligible adults (n = 9403), only 937 (10.4%) respondents underwent CRC screening using FOBT/FIT within the past year; among this screening population, 279 (28.3%) respondents were screened in‐office. We found that sociodemographic factors alone, not CRC risk factors, determined whether FOBT/FIT would be used in‐office or at home. Hispanics had greater odds of being screened in‐office using FOBT/FIT (aOR: 2.04; 95% CI: 1.05‐3.99). Compared with those 50‐59 years old, respondents 70‐75 years old were less likely to be screened in‐office using FOBT/FIT (aOR: 0.44, 95% CI: 0.25‐0.79). Similarly, individuals residing in the Western region of the country had lower odds of in‐office FOBT/FIT (aOR: 0.26; 95% CI: 0.11‐0.58). Conclusion Amid low overall uptake rates of FOBT/FIT in the United States, in‐physician office testing is high, indicative of a missed opportunity for effective screening and poor adherence of physicians to national guidelines. Sociodemographic factors are determinants of uptake of FOBT/FIT at home or in‐office and should be considered in designing interventions aimed at providers and the general population.

Metabolic profiling analysis for clinical urine of colorectal cancer

“…However, considering the difficulty of changing major lifestyles and implementing a wide range of primary prevention strategies, colorectal screening of the general population is the most effective public health tool to reduce the incidence and mortality of CRC. Over the past few decades, researchers proposed several test methods for CRC screening, including fecal occult blood test (FOBT), fecal immunochemical test (FIT), 5 and other inspection methods such as colonoscopy 6 or computed tomography (CT) 7 . However, disadvantages of these methods include high false positive rate of FOBT, 8 high false negative rate of FIT, 9 and high invasiveness and medical costs of the endoscopic and CT examinations.…”

IgM and IgA augmented autoantibody signatures improve early‐stage detection of colorectal cancer prior to nodal and distant spread

“…Despite a rapid decline in CRC incidence rates during the 2000s, mostly because of the introduction of population screening modalities, such as colonoscopy and faecal occult blood‐based tests (FOBT), the overall decline in CRC incidence rates and mortality has waned in more recent years 2 . The plateauing of mortality rates in CRC in recent years could be attributed to, among others, poor uptake of stool‐based screening 3,4 and the rise in early‐onset CRC incidence by 1–4% among the younger population (age < 50) 1 . CRC mortality is mainly attributed to nodal and distant metastatic disease often in individuals not diagnosed until the advanced and symptomatic disease has developed 2,5 .…”

A proteomic classifier panel for early screening of colorectal cancer: a case control study

“…Taking into consideration the CRC prevalence of around 0.25% in Chinese population [ 45 ] with the sensitivity of 81.5% and specificity of 97.9%, the calculated NPV of our assay can reach 99.95%. The sensitivity and specificity of our assay compare favorably to existing clinical diagnosis and screening methods including stool FOBT/FIT [ 5 ], blood and stool DNA methylation test [ 6 , 7 ], and performs similarly to an FDA approved, stool-based DNA test (Cologuard) [ 14 ], well suited for early screen. Fourth, because sampling blood is more convenient than procuring stool samples and its non-invasive nature surpasses colonoscopy, patient compliance is expected to be much better than conventional diagnostic methods.…”

“…There are also a number of stool- and blood-based non-invasive screening methods to aid the detection of CRC at early stages [ 4 ]. The FOBT/FIT uses immunoassay to measure the hemoglobin in the stool [ 5 ]. Two DNA tests measure the methylation status at the promoter region of mSEPT9 or SDC2 gene in the blood and the stool respectively [ 6 , 7 ].…”