Fecal Immunologic Test Results and Diagnostic Colonoscopy in a Mexican Population at Average Risk for Colorectal Cancer

Abstract

◥Colorectal cancer is preventable and treatable by screening and early detection. Fecal immunochemical tests (FIT) for average risk individuals is an effective strategy for screening. Incidence and mortality in Mexico is increasing and largescale screening programs do not yet exist. The aim of this study was to evaluate the feasibility of FIT-based colorectal cancer screening program in Mexico City. For more than 15 months, average risk individuals in Mexico City were invited to participate at Mexico's Instituto Nacional de Cancerologia (INCan, Mexico City, Mexico). Participants received an FIT kit for stool collection, results ≥20 ng/mL were referred for high quality colonoscopy. Participants' results were classified according to the most advanced clinical finding as: adenocarcinoma, high-risk adenomas, low-risk adenomas, serrated lesions, hyperplastic polyps, and no polyps. Sequential analyses were performed to assess the positive predictive value (PPV) of FIT. A total of 810 participants were eligible, 737 (91.0%) returned the FIT and 112 (15.2%) had an abnormal result. Of these participants, 87 (77.7%) completed colonoscopy. Clinical findings of participants included: seven (8.1%) adenocarcinomas, 18 (20.7%) high-risk adenomas, 23 (26.4%) low-risk adenomas, one (1.2%) serrated lesions, 14 (16.1%) hyperplasic polyps, and 24 (27.6%) no polyps. The PPV of FIT using the ≥20 ng/mL was 8.1% for cancer and 20.7% for highrisk adenomas. In conclusion, colorectal cancer screening with FIT is feasible at INCan in Mexico City, where resources are available. Further studies are needed to determine feasibility of colorectal cancer screening in other settings, as well as optimal hemoglobin detection cut-off points to maximize the population benefits of colorectal cancer screening with FIT in Mexico.

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

“…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].…”

Developing a collaborative international partnership for cancer control in Mexico

“…11,14 The collaboration team has undertaken a multi-pronged approach to evaluate the feasibility and acceptability of CRC screening in this context. [15][16][17] Ultimately, the partnership aims to develop and implement a feasible and cost-effective screening program that addresses the context-specific barriers through a multi-level approach.…”

MicroRNA panels as diagnostic biomarkers for colorectal cancer: A systematic review and meta-analysis

“…Combination chemotherapy, differing novel systemic and regional multimodality therapies, metastasectomies, and other local treatments, such as hyperthermic intraperitoneal chemotherapy, are all emerging therapies for metastatic CRC (3,4). However, even though screening techniques such as colonoscopy, fecal-based diagnostic and plasma-based assays for early identification are available, their diagnostic use is limited owing to prohibitive costings and low patient compliance (5)(6)(7)(8)(9)(10). Consequently, there is an urgent need for novel diagnostic and prognostic biomarkers for the early diagnosis of CRC.…”