TY - JOUR
T1 - Impact of age- and gender-specific cut-off values for the fecal immunochemical test for hemoglobin in colorectal cancer screening
AU - Alvarez-Urturi, Cristina
AU - Andreu, Montserrat
AU - Hernandez, Cristina
AU - Perez-Riquelme, Francisco
AU - Carballo, Fernando
AU - Ono, Akiko
AU - Cruzado, Jose
AU - Cubiella, Joaquín
AU - Hernandez, Vicent
AU - Mao, Carmen Gonzalez
AU - Perez, Elena
AU - Salas, Dolores
AU - Andrés, Mercedes
AU - Bujanda, Luis
AU - Portillo, Isabel
AU - Sarasqueta, Cristina
AU - Quintero, Enrique
AU - Morillas, Juan Diego
AU - Lanas, Angel
AU - Sostres, Carlos
AU - Augé, Josep Maria
AU - Castells, Antoni
AU - Bessa, Xavier
PY - 2016/5/1
Y1 - 2016/5/1
N2 - © 2016 Editrice Gastroenterologica Italiana S.r.l. Background: There is no information on the impact of age and gender on the diagnostic yield of different positivity thresholds for the fecal immunochemical test for hemoglobin (FIT). Objectives: To evaluate the performance of this test at distinct positivity cut-offs in a population-based colorectal cancer (CRC) screening program. Methods: CRC detection rate (DR), and analysis of resources were evaluated retrospectively, at different cut-offs of FIT (20, 25, 30, 35 and 40 μg Hb/g) respect to a reference value (15 μg Hb/g), according to age and gender, in a screening population of 10,611 participants of the ColonPrev study (Quintero. NEJM 2013). Results: At the reference cut-off value, 36 CRC and 252 advanced adenomas (AA) were diagnosed. Increasing the cut-off in women ≤60 years decreases colonoscopies performed by 44.5% without modifying the CRC (DR). Same CRC DR was observed in men ≤60 years and women >60 years increasing cut-off at 25-30 μg Hb/g. In men >60 years, all increases in the cut-off affected the CRC DR, especially when the cut-off was increased from 35 to 40 μg Hb/g (CRC miss rate 25%). Conclusions: To improve the performance of FIT in CRC screening programs, FIT cut-offs could be individualized by age and gender.
AB - © 2016 Editrice Gastroenterologica Italiana S.r.l. Background: There is no information on the impact of age and gender on the diagnostic yield of different positivity thresholds for the fecal immunochemical test for hemoglobin (FIT). Objectives: To evaluate the performance of this test at distinct positivity cut-offs in a population-based colorectal cancer (CRC) screening program. Methods: CRC detection rate (DR), and analysis of resources were evaluated retrospectively, at different cut-offs of FIT (20, 25, 30, 35 and 40 μg Hb/g) respect to a reference value (15 μg Hb/g), according to age and gender, in a screening population of 10,611 participants of the ColonPrev study (Quintero. NEJM 2013). Results: At the reference cut-off value, 36 CRC and 252 advanced adenomas (AA) were diagnosed. Increasing the cut-off in women ≤60 years decreases colonoscopies performed by 44.5% without modifying the CRC (DR). Same CRC DR was observed in men ≤60 years and women >60 years increasing cut-off at 25-30 μg Hb/g. In men >60 years, all increases in the cut-off affected the CRC DR, especially when the cut-off was increased from 35 to 40 μg Hb/g (CRC miss rate 25%). Conclusions: To improve the performance of FIT in CRC screening programs, FIT cut-offs could be individualized by age and gender.
KW - Colorectal cancer screening
KW - Cut-off values
U2 - 10.1016/j.dld.2016.02.001
DO - 10.1016/j.dld.2016.02.001
M3 - Article
VL - 48
SP - 542
EP - 551
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 5
ER -