T1094 Diagnostic Yield of Screening for Colorectal Cancer in the Netherlands; Randomized Controlled Trial Comparing Two Different Forms of Faecal Occult Blood Testing and Sigmoidoscopy

Hol, Lieke; Kuipers, Ernst J.; Ballegooijen, Marjolein van; Vuuren, Anneke van; Reijerink-Verheij, Jaqueline C.; Leeuwen, Alexandra C. van der Togt-van; Habbema, J.D.; van, M.E. Leerdam

doi:10.1016/s0016-5085(08)62255-6

Cited by 2 publications

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“…In a review by Hewitson et al ,5 the positivity rate of the G-FOBT varied from 0.8% to 5.3%, and other studies showed I-FOBT positivity rates of 4.7% and 6.9% 8 28. In this study, 2.4% of returned G-FOBTs and 8.5% of returned I-FOBTs with 50 ng/ml cut-off were positive 18 19. A higher positivity rate of the FOBT consequently results in a higher number of false positives, which would make CTC as triage more efficient.…”

Section: Discussionmentioning

confidence: 45%

“…A total of 248 participants had a positive I-FOBT and 54 participants had a positive G-FOBT. This difference was due to the differences in FOBT participation rate (I-FOBT had a 12.7% higher participation rate) and FOBT positivity rate; 2.4% of returned tests was positive for the G-FOBT and 8.5% for the I-FOBT with 50 ng/ml cut-off 18 19 26…”

Section: Resultsmentioning

confidence: 99%

“… 8 28 In this study, 2.4% of returned G-FOBTs and 8.5% of returned I-FOBTs with 50 ng/ml cut-off were positive. 18 19 A higher positivity rate of the FOBT consequently results in a higher number of false positives, which would make CTC as triage more efficient. The PPV of the I-FOBT was indeed lower than that of the G-FOBT; however, still 46% of patients in the I-FOBT group had an adenoma or cancer ⩾10 mm.…”

Section: Discussionmentioning

confidence: 99%

“…This was the first pilot study of CRC screening in The Netherlands, thus invitees had not received any other CRC screening test previously. The results of this FOBT pilot study have been reported in detail elsewhere 18 19. The FOBT-positive patients scheduled to undergo colonoscopy were invited to undergo a CTC before the colonoscopy at the Academic Medical Centre of Amsterdam, Radboud University Nijmegen Medical Centre or the Erasmus Medical Centre of Rotterdam, The Netherlands.…”

Section: Methodsmentioning

confidence: 99%

“…The results of this FOBT pilot study have been reported in detail elsewhere. 18 19 The FOBT-positive patients scheduled to undergo colonoscopy were invited to undergo a CTC before the colonoscopy at the Academic Medical Centre of Amsterdam, Radboud University Nijmegen Medical Centre or the Erasmus Medical Centre of Rotterdam, The Netherlands. Exclusion criteria were: terminal illness, severe psychiatric symptoms, colonoscopy or another FOBT in the previous 2 years, examinations for research purposes with radiation exposure in the last 12 months, iodine contrast allergy, hyperthyroidism and pregnancy.…”

Section: Methodsmentioning

confidence: 99%

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Using CT colonography as a triage technique after a positive faecal occult blood test in colorectal cancer screening

Liedenbaum

Rijn

Vries

et al. 2009

Gut

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Objective:The purpose of this study was to evaluate the effectiveness of CT colonography (CTC) as a triage technique in faecal occult blood test (FOBT)-positive screening participants.Methods:Consecutive guaiac (G-FOBT) and immunochemical (I-FOBT) FOBT-positive patients scheduled for colonoscopy underwent CTC with iodine tagging bowel preparation. Each CTC was read independently by two experienced observers. Per patient sensitivity, specificity and positive and negative predictive values (PPV and NPV) were calculated based on double reading with different CTC cut-off lesion sizes using segmental unblinded colonoscopy as the reference standard. The acceptability of the technique to patients was evaluated with questionnaires.Results:302 FOBT-positive patients were included (54 G-FOBT and 248 I-FOBT). 22 FOBT-positive patients (7%) had a colorectal carcinoma and 211 (70%) had a lesion ⩾6 mm. Participants considered colonoscopy more burdensome than CTC (p<0.05). Using a 6 mm CTC size cut-off, per patient sensitivity for CTC was 91% (95% CI 85% to 91%) and specificity was 69% (95% CI 60% to 89%) for the detection of colonoscopy lesions ⩾6 mm. The PPV of CTC was 87% (95% CI 80% to 93%) and NPV 77% (95% CI 69% to 85%). Using CTC as a triage technique in 100 FOBT-positive patients would mean that colonoscopy could be prevented in 28 patients while missing ⩾10 mm lesions in 2 patients.Conclusion:CTC with limited bowel preparation has reasonable predictive values in an FOBT-positive population and a higher acceptability to patients than colonoscopy. However, due to the high prevalence of clinically relevant lesions in FOBT-positive patients, CTC is unlikely to be an efficient triage technique in a first round FOBT population screening programme.

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Section: Discussionmentioning

confidence: 45%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Using CT colonography as a triage technique after a positive faecal occult blood test in colorectal cancer screening

Liedenbaum

Rijn

Vries

et al. 2009

Gut

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Bevolkingsonderzoek naar darmkanker

Jansen¹,

Laheij²,

Rossum³

2009

BIJB

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Nationwide colorectal cancer screening Usually, colorectal cancer presents with complaints in a late stage, but can be detected in an earlier stage, with better prognosis, by colonoscopy. Using colonoscopy, also precancerous tumours, adenomas, can be detected and excised, but only in a national screening programme. However primary screening with colonoscopy is too burdensome and expensive. Out of all the screening alternatives, only of the faecal occult blood tests (faeces tests) a decreased colorectal cancer mortality has been proven. It stands to reason that the new generation immunochemical faeces tests, can reduce colorectal cancer mortality more effectively, and these tests have, more than the alternatives, a good balance between efficiency, straightforwardness and costs. Recently, the Dutch National Health Council recommended to introduce nationwide colorectal cancer screening, using an immunochemical faecal occult blood test Bron

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T1094 Diagnostic Yield of Screening for Colorectal Cancer in the Netherlands; Randomized Controlled Trial Comparing Two Different Forms of Faecal Occult Blood Testing and Sigmoidoscopy

Cited by 2 publications

References 0 publications

Using CT colonography as a triage technique after a positive faecal occult blood test in colorectal cancer screening

Using CT colonography as a triage technique after a positive faecal occult blood test in colorectal cancer screening

Bevolkingsonderzoek naar darmkanker

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