Comparison of a New-generation Fecal Immunochemical Test (FIT) With Guaiac Fecal Occult Blood Test (gFOBT) in Detecting Colorectal Neoplasia Among Colonoscopy-referral Patients

Guimarães, Denise Peixoto; Fregnani, José Humberto Tavares Guerreiro; Reis, Rui Manuel; Taveira, Leonardo Nogueira; Scapulatempo‐Neto, Cristovam; Matsushita, Marcus; Silva, Sandra Regina Morini; Oliveira, Ceyton Zanardo; Longatto‐Filho, Adhemar; Eklund, Carita; Paloheimo, Lea; Mauad, Edmundo Carvalho; Suovaniemi, Osmo; Syrjänen, Karí

doi:10.21873/anticanres.13106

Cited by 19 publications

(63 citation statements)

References 23 publications

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“…For the adenoma endpoint, the difference in sensitivity between ColonView test and gFOBT was even larger (sensitivity of 44% versus 19%, respectively). The authors concluded that due to its 95% sensitivity, ColonView test is superior to gFOBT in organized CRC screening (27).…”

Section: Fitsmentioning

confidence: 99%

“…The FIT is based on the detection of the globin moiety of human hemoglobin or its degradation products. In a recent systematic review of FITs in CRC screening (21,27), 12 types of FITs were identified in the literature, representing 20 different proprietary names. Due to the major differences in test methodology, the authors were unable to assess all FITs as a class, however, and undertook a sub-group analysis (15,21).…”

Section: Fitsmentioning

confidence: 99%

“…In this meta-analysis, the pooled sensitivity and specificity for the CRC endpoint were: 79% (95% CI=69-86%) and 94% (95% CI=93-97%), respectively (39). These meta-analytical results are supplemented by two separate studies testing ColonView in head-to-head comparison with gFOBT (Hemoccult SENSA; Beckman Coulter, Pasadena, Los Angeles, CA, USA) (26,27). In a St. Petersburg study of a cohort of 300 patients referred for colonoscopy, the ColonView test showed pooled sensitivity of 100% and specificity of 95% for proximal colon neoplasia as well as 98% sensitivity and 95% specificity for distal colon neoplasia (26).…”

Section: Fitsmentioning

confidence: 99%

“…The gFOBT was the first technology on the market, and its clinical efficacy has been investigated more extensively than that of FITs (22)(23)(24)(25). Because gFOBTs are not specific for human blood, it is necessary to confirm a FOBT-positive result by colonoscopy (26,27).…”

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confidence: 99%

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Colorectal Cancer Screening With Traditional and New-generation Fecal Immunochemical Tests: A Critical Review of Fecal Occult Blood Tests

2020

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Previous randomized studies suggest that fecal occult blood test (FOBT) screening can reduce mortality from colorectal cancer (CRC). Our aim was to review the current status of FOBTs in CRC screening. FOB is measured using either the traditional guaiac-based tests or more recently introduced fecal immunochemical tests (FITs). FITs have several advantages over guaiac-based FOBTs, including higher sensitivity and specificity, resulting in improved clinical performance and higher efficiency. Another advantage in population screening according to European Guidelines for quality assurance in CRC screening is that FITs can be automated and user can adjust the cutoff at which a positive result is reported. In population-based screening, all those testing positively with any FOBT should be referred for colonoscopy. Conclusion: Although a plethora of FOBTs are available on the market, relatively few have been extensively tested for clinical sensitivity and specificity in CRC screening. Current data imply that new FITs have superior test characteristics as compared with guaiac-based FOBTs. The latest development in the field is represented by the proteomic-based tests that may further reduce false-negative rates in CRC screening. Simple stool sample preservation and automatic analysis are other important issues in population-based screening for CRC. Colorectal cancer (CRC) is the third most common cancer worldwide, with over 1.3 million new cases and over 600,000 deaths each year (1). In Finland, the incidence of CRC is lower than in many Western countries but mortality is quite similar, reflecting a mortality-to-incidence ratio disparity in Finland. During the 3-year period of 2015 to 2017, incident CRC was encountered in 4,577 women and in 5,131 in men, with an estimated annual average of 3,236 new CRC cases (2). After lung cancer, CRC is the second most common cause of cancer deaths among men and women combined in Finland (2). The majority of CRCs develop from adenomas or adenomatous polyps and several studies have shown the efficacy of screening for detection of large adenomas. CRC screening can achieve the goals of both primary prevention (by detecting cancer precursors: polyps, adenomas) and secondary prevention (by detecting early cancers) (3, 4). Thus, organized CRC screening offers a possibility for cancer prevention and early detection of cancer, with reduced mortality (5, 6). Although a plethora of fecal occult blood test (FOBT) are available on the market, relatively few of them have been extensively tested for clinical sensitivity and specificity in CRC screening. The main aim for the use of FOBTs is to reduce CRC mortality (7-11). European Guidelines for quality assurance in CRC screening recommend fecal immunochemical tests (FITs) because FITs have improved test characteristics compared to guaiac-based FOBTs (gFOBTs) (12) (Table I). The most commonly used CRC screening tests include flexible sigmoidoscopy, colonoscopy and FOBT (13, 14). Lin et al. reviewed literature and found four randomized clinical trials...

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Section: Fitsmentioning

confidence: 99%

Section: Fitsmentioning

confidence: 99%

Section: Fitsmentioning

confidence: 99%

mentioning

confidence: 99%

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Colorectal Cancer Screening With Traditional and New-generation Fecal Immunochemical Tests: A Critical Review of Fecal Occult Blood Tests

2020

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“…Study Population. This retrospective study analyzed a total of 90 formalin-xed para n-embedded (FFPE) samples removed from 87 patients during diagnostic colonoscopy from 2014 to 2016 at Barretos Cancer Hospital 57 . Samples included 67 adenomas (39 early and 28 advanced adenomas), 7 sessile serrated lesions and 16 hyperplastic polyps.…”

Section: Methodsmentioning

confidence: 99%

Somatic targeted mutation profiling of colorectal cancer precursor lesions

Santos¹,

Reis²,

Porto³

et al. 2021

Preprint

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Most colorectal cancers (CRC) arise from precursor lesions. We aimed to characterize the mutation profile of CRC precursor lesions in a Brazilian population. In total, 90 FFPE lesions, including 67 adenomas, 7 sessile serrated lesions, and 16 hyperplastic polyps, were analyzed by next-generation sequencing. The genetic ancestry of the patients was estimated. Somatic driver mutations were identified in 66.7% of cases, including alterations in APC (32.2%), TP53 (20.0%), KRAS (18.9%), BRAF (13.3%) and EGFR (7.8%). Adenomas displayed a higher number of mutations, mainly in APC, compared to serrated polyps (73.1% vs. 47.8%, p = 0.039). Advanced adenomas had a higher frequency of mutation in KRAS and GNAS and a high overall mutation rate than early adenomas (92.9% vs. 59%, p = 0.002). Concerning the serrated pathway, a higher frequency of mutations, mainly in BRAF, was observed in sessile serrated lesions (85.7%) compared to hyperplastic polyps (31.3%, p = 0.027). A high degree of ancestry admixture was observed in the population, with a predominance of European followed by African components. The mutation profile of Brazilian colorectal precursor lesions exhibits a similar landscape to other populations. These results bestow the knowledge of CRC's biological history and may contribute to a molecular screening approach.

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