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Optimizing sampling device for the fecal immunochemical test increases colonoscopy yields in colorectal cancer screening
- Source :
- European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP). 25(2)
- Publication Year :
- 2015
-
Abstract
- The fecal immunochemical test (FIT) that quantifies hemoglobin concentration is reported to be better than qualitative FIT and the reason for its superiority has not been interpreted. To evaluate and understand the superiority of quantitative FIT, a representative randomly selected population (n=2355) in Jiashan County, China, aged 40-74 years was invited for colorectal cancer screening in 2012. Three fecal samples were collected from each participant by one optimized and two common sampling devices, and then tested by both quantitative and qualitative FITs. Colonoscopy was provided independently to all participants. The performances of five featured screening strategies were compared. A total of 1020 participants were eligible. For screening advanced neoplasia, the positive predictive value (PPV) and the specificity of the strategy that tested one sample dissolved in an optimized device by quantitative FIT [PPV=40.8%, 95% confidence interval (CI): 27.1-54.6; specificity=96.8%, 95% CI: 95.7-98.0] were significantly improved over the strategy that tested one sample dissolved in the common device by qualitative FIT (PPV=14.1%, 95% CI: 8.2-19.9; specificity=87.9%, 95% CI: 85.8-89.9), whereas the sensitivity did not differ (39.2 and 37.3%, P=0.89). Similar disparity in performance was observed between the strategies using qualitative FIT to test one sample dissolved in optimized (PPV=29.5%, 95% CI: 18.1-41.0; specificity=95.3%, 95% CI: 94.0-96.7) versus common sampling devices. High sensitivity for advanced neoplasia was observed in the strategy that tested two samples by qualitative FIT (52.9%, 95% CI: 39.2-66.6). Quantitative FIT is better than qualitative FIT for screening advanced colorectal neoplasia. However, the fecal sampling device might contribute most significantly toward the superiority of quantitative FIT.
- Subjects :
- Adenoma
Adult
Male
Cancer Research
medicine.medical_specialty
China
Time Factors
Epidemiology
Population
Colonoscopy
Gastroenterology
Sampling device
Specimen Handling
Immunoenzyme Techniques
Hemoglobins
Internal medicine
medicine
Humans
education
Early Detection of Cancer
Aged
Neoplasm Staging
education.field_of_study
medicine.diagnostic_test
business.industry
Public Health, Environmental and Occupational Health
Follow up studies
Middle Aged
Prognosis
Predictive value
Confidence interval
Oncology
Fecal Immunochemical Test
Colorectal cancer screening
Occult Blood
Female
Reagent Kits, Diagnostic
business
Colorectal Neoplasms
Follow-Up Studies
Subjects
Details
- ISSN :
- 14735709
- Volume :
- 25
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP)
- Accession number :
- edsair.doi.dedup.....44b64ea6dd688378f69a8f5008901d5c