Correlation of Fecal Immunochemical Testing Levels With Pathology Results in a National Colorectal Cancer Screening Program

O’Reilly, Susanne M.; MacNally, S.; O’Donoghue, Diarmuid; Mooney, Therese; Fitzpatrick, Patricia; Mulcahy, Hugh; Cullen, Garret

doi:10.14309/ctg.0000000000000277

Cited by 6 publications

(2 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Seventyfive full-length articles were assessed for inclusion and 23 studies were included in the final analysis [19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41]. Sixteen studies reported SSPDR after only FIT testing [19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34], three reported SSPDR on both FIT and FIT-DNA [35,36,37], and three studies reported SSPDR after only FIT-DNA testing (▶ Fig. 1) [38,39,40,41].…”

Section: Search Results and Population Characteristicsmentioning

confidence: 99%

Sessile serrated polyp detection rates after fecal immunochemical test or multitarget stool DNA test: Systematic review and meta-analysis

Garg,

Burke,

Aggarwal

et al. 2024

Endosc Int Open

View full text Add to dashboard Cite

Background: Published studies report a higher adenoma detection rate (ADR) for FIT-DNA as compared to FIT. Data is less replete on the performance of stool-based tests on sessile serrated polyp (SSP) detection. We performed meta-analysis to evaluate the performance of FIT and FIT-DNA test on SSP detection rate (SSPDR) for patients undergoing colonoscopy for follow up of positive noninvasive tests. Methods A comprehensive literature search of multiple databases (until September 2022) was performed to identify studies reporting SSPDR in patients with positive FIT or FIT-DNA. The outcome was overall colonoscopy detection of any SSP and an advanced serrated polyps (ASP: SSP ≥ 10 mm and/or dysplasia) Results 482,405 (52.4% females) patients with a mean age of 62.3 ± 4.4 years were included from 23 studies. The pooled SSPDR for all positive stool-based tests was 5.3% and higher for FIT-DNA (15.0%, 95% CI: 8.3 – 25.7) versus FIT (4.1%, 95% CI: 3.0 – 5.6; p=0.0002). The overall pooled ASP detection rate was 1.4% (95% CI: 0.81 – 2.3) and higher in FIT-DNA (3.8 %, 95% CI: 1.7 – 8.6) compared to FIT (0.71%, 95% CI: 0.36 – 1.4; p< 0.01). SSPDR with FIT-DNA was also significantly higher than FIT where FIT cutoff was >10 ug/g and in FIT positive patients in studies conducted in North America (p<0.05). Conclusion FIT-DNA outperformed FIT in both SSP and ASP detection including FIT with a lower threshold cutoff >10 ug/g. Further comparative studies are needed to assess impact of our findings on colorectal cancer reduction.

show abstract

Section: Search Results and Population Characteristicsmentioning

confidence: 99%

Sessile serrated polyp detection rates after fecal immunochemical test or multitarget stool DNA test: Systematic review and meta-analysis

Garg,

Burke,

Aggarwal

et al. 2024

Endosc Int Open

View full text Add to dashboard Cite

show abstract

“…The findings were also reproduced by the Austrian researchers (3). This is interesting, as FIT level is associated with adenoma size (27). Secondly, adherence to surveillance is crucial, and FIT may make up a first option for patients who hesitate to undergo colonoscopy or bowel cleansing for psychological reasons, for patients with severe comorbidity, or for those living far away from nearest endoscopy unit (28).…”

Section: Discussionmentioning

confidence: 99%

Accuracy of a faecal immunochemical test in patients under colonoscopy surveillance of colorectal adenoma and cancer

Olsson

Sjöberg

2023

ujms

View full text Add to dashboard Cite

Background: Surveillance of colorectal neoplasia place great strain on colonoscopy resources, and faecal immunochemical tests (FIT) are under-investigated for this purpose. The aim of this study was to report the outcome of FIT among patients scheduled for post-polypectomy and post-resection colorectal cancer (CRC) surveillance. Methods: Patients scheduled for colonoscopy surveillance at five endoscopy units in mid-Sweden in 2016–2020 were eligible. They provided a faecal sample from 2 separate days, which were analysed by iFOBT QuikRead go® (Aidian Oy). Both the colonoscopies, and the FIT analyses were conducted by staff blinded to the other. Results: Out of 216 included patients, 157 (73%) underwent both a complete colonoscopy and had at least one FIT analysed prior to the examination. The indication for surveillance was previous adenoma in 69 (44%) and post-resection CRC in 88 (56%) patients. Two (1%) in the CRC surveillance group were diagnosed with a metachronous CRC, whereas 49 (56%) patients in the CRC surveillance, and 17 (25%) in the adenoma group had no pathology identified at colonscopy (P < 0.001). The proportion of patients diagnosed with adenomas requiring surveillance according to European Society of Gastrointestinal Society (ESGE) guidelines 2020 was 6 (7%) in the post-CRC resection versus 7 (10%) in the adenoma surveillance group (P = 0.4). Based on one FIT and at cut-off 10 µg Hb/g, sensitivity for CRC was 100%, specificity 83% (95% confidence interval [CI]: 77–89), Positive Predictive Value (PPV) 7% (−2 to 16) and Negative Predictive Value (NPV) 100%. All patients with an adenoma requiring surveillance had a FIT below this cut-off. Adding a second FIT decreased the specificity. Conclusion: Larger studies to evaluate the accuracy and consequences of using FIT for surveillance of colorectal neoplasia are needed. FIT may be more interesting for post-resection CRC surveillance than follow-up of adenoma.

show abstract

Using fecal immunochemical test values below conventional cut-off to individualize colorectal cancer screening

et al. 2022

View full text Add to dashboard Cite

Background and study aims Of the participants in the Danish screening program, 89.9 % to 92.5 % have fecal immunochemical test (FIT) values < 10 μg/g feces (equivalent to 50 ng hemoglobin/mL buffer). This study aimed to investigate the risk of interval colorectal cancer (CRC) in this group before the next biennial screening round. Patients and methods This cohort study included all citizens from the region of Southern Denmark who participated in the Danish bowel screening program from 2014 trough 2016 and had a FIT value < 10 μg/g feces. Individuals receiving a CRC diagnosis were identified through the national CRC registry, with a follow up of 2 years corresponding to the current screening interval. We also examined the 3-year CRC incidence. Hazard ratios (HRs) were estimated using univariate and multivariate Cox proportional hazard regression models. Results Data from 185,654 citizens presenting with a FIT value < 10 μg/g feces were eligible for analysis. Overall, interval CRC incidence was 0.07 % within 2 years with HRs of 4.16 (95 % confidence interval [CI] 2.67;6.48) and 5.8 (95 % CI 3.34;10.05) for FIT values of 4 to 6.9 μg/g feces and 7 to 9.9 μg/g feces, respectively, compared to those having a FIT value below the limit of quantification of 4 μg/g feces. After 3 years, the overall CRC incidence increased to 0.14 %; however, this was not significant. Conclusions This study demonstrates a positive correlation between FIT value and risk of interval cancer even for very low values. It further suggests that an increase in the screening interval could be reasonable in the low FIT categories.

show abstract

Correlation of Fecal Immunochemical Testing Levels With Pathology Results in a National Colorectal Cancer Screening Program

Cited by 6 publications

References 21 publications

Sessile serrated polyp detection rates after fecal immunochemical test or multitarget stool DNA test: Systematic review and meta-analysis

Sessile serrated polyp detection rates after fecal immunochemical test or multitarget stool DNA test: Systematic review and meta-analysis

Accuracy of a faecal immunochemical test in patients under colonoscopy surveillance of colorectal adenoma and cancer

Using fecal immunochemical test values below conventional cut-off to individualize colorectal cancer screening

Contact Info

Product

Resources

About