1. Screening for colorectal cancer: random comparison of guaiac and immunochemical faecal occult blood testing at different cut-off levels
- Author
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A C M van der Togt, Janneke Wilschut, Jacqueline C. Reijerink, A J van Vuuren, H van der Valk, M. van Ballegooijen, E. J. Kuipers, Lieke Hol, J. D. F. Habbema, M E van Leerdam, Epidemiology and Data Science, CCA - Cancer biology and immunology, AII - Cancer immunology, Gastroenterology and hepatology, Gastroenterology & Hepatology, Public Health, and Pathology
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,cut-off ,guaiac-based faecal occult blood test ,Colorectal cancer ,Population ,Colonoscopy ,Gastroenterology ,Sensitivity and Specificity ,colorectal cancer screening ,population based ,Hemoglobins ,SDG 3 - Good Health and Well-being ,Internal medicine ,Cancer screening ,medicine ,Humans ,education ,Molecular Diagnostics ,Aged ,Average risk ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Immunochemistry ,Faecal occult blood ,Middle Aged ,immunochemical faecal occult blood test ,medicine.disease ,randomised trial ,Surgery ,Oncology ,Occult Blood ,Female ,Cut-off ,Faecal occult blood test ,business ,Colorectal Neoplasms ,Guaiac - Abstract
Immunochemical faecal occult blood testing (FIT) provides quantitative test results, which allows optimisation of the cut-off value for follow-up colonoscopy. We conducted a randomised population-based trial to determine test characteristics of FIT (OC-Sensor micro, Eiken, Japan) screening at different cut-off levels and compare these with guaiac-based faecal occult blood test (gFOBT) screening in an average risk population. A representative sample of the Dutch population (n=10 011), aged 50-74 years, was 1 : 1 randomised before invitation to gFOBT and FIT screening. Colonoscopy was offered to screenees with a positive gFOBT or FIT (cut-off 50 ng haemoglobin/ml). When varying the cut-off level between 50 and 200 ng ml(-1), the positivity rate of FIT ranged between 8.1% (95% CI: 7.2-9.1%) and 3.5% (95% CI: 2.9-4.2%), the detection rate of advanced neoplasia ranged between 3.2% (95% CI: 2.6-3.9%) and 2.1% (95% CI: 1.6-2.6%), and the specificity ranged between 95.5% (95% CI: 94.5-96.3%) and 98.8% (95% CI: 98.4-99.0%). At a cut-off value of 75 ng ml(-1), the detection rate was two times higher than with gFOBT screening (gFOBT: 1.2%; FIT: 2.5%; P
- Published
- 2009
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