Immunochemical faecal occult blood testing to screen for colorectal cancer: can the screening interval be extended?

Haug, Ulrike; Grobbee, Esmée J.; Lansdorp–Vogelaar, Iris; Spaander, Manon C.W.; Kuipers, Ernst J.

doi:10.1136/gutjnl-2015-310102

Cited by 18 publications

(15 citation statements)

References 17 publications

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“…In fact, increased use of this test instead of FIT or other established CRC screening options, such as flexible sigmoidoscopy and colonoscopy, could strongly compromise the otherwise excellent cost-effectiveness of CRC screening consistently demonstrated in multiple studies24–29 even if longer screening intervals, such as 3- rather than the 1- or 2-year intervals commonly recommended for FIT,30 should be sufficient for this test. Empirical data supporting prolongation of screening intervals have recently become available for FIT,31 whereas we are not aware of such data for the MSDT. Whether this test should be considered the new high bar benchmark for noninvasive CRC screening as previously claimed9 therefore appears debatable.…”

Section: Discussionmentioning

confidence: 98%

Fecal occult blood versus DNA testing: indirect comparison in a colorectal cancer screening population

Brenner

Chen

2017

CLEP

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BackgroundA multitarget stool DNA test (MSDT) that showed higher sensitivity but lower specificity than a fecal immunochemical test (FIT) for hemoglobin in one recent study from the US and Canada, is increasingly used for colorectal cancer (CRC) screening, despite its ~20-fold higher costs compared to FITs. We aimed to assess diagnostic performance of a quantitative FIT in an independent study among participants of screening colonoscopy and to compare it with the previously reported performance of MSDT.MethodsA total of 3494 participants, aged 50–84 years, who underwent screening colonoscopy in private gastroenterological practices in Germany, and who provided a stool sample before colonoscopy to be evaluated by a commercially available quantitative FIT (FOB Gold®) were included. Diagnostic performance (sensitivity, specificity) for detecting CRC or advanced precancerous lesions (APCLs) was evaluated by comparison of test results with findings at screening colonoscopy. In addition to the original cutoff, we used an adjusted cutoff yielding the same specificity as reported for the MSDT to enhance comparability.ResultsThe most advanced finding at colonoscopy was CRC and APCL in 30 (0.86%) and 359 (10.3%) cases, respectively. At a cutoff yielding the same specificity as reported for MSDT (86.6%), the sensitivities (95% CI) of the FIT for detecting CRC and APCL >1 cm were 96.7% (82.8–99.9%) and 54.3% (48.3–60.3%), respectively. These sensitivities are higher than those reported for MSDT (92.3% and 43.6%, p=0.66 and 0.003, respectively).ConclusionIn this large screening population, FIT showed equivalent or better diagnostic performance in comparison to reported performance of MSDT.

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Section: Discussionmentioning

confidence: 98%

Fecal occult blood versus DNA testing: indirect comparison in a colorectal cancer screening population

Brenner

Chen

2017

CLEP

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“…We read with interest the work by Haug et al published in Gut 1. Longitudinal data from 4523 participants in the first round of a faecal immunochemical test for haemoglobin (FIT)-based screening programme, of whom 3427 also participated in the second round, were studied.…”

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confidence: 99%

Can the performance of a quantitative FIT-based colorectal cancer screening programme be enhanced by lowering the threshold and increasing the interval?

Digby

Fraser

Carey

et al. 2017

Gut

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“…Screening reduces mortality by 15-25%, but the hope is to improve these figures. As far as FIT is concerned, a new study proposed an improvement of the FIT increasing the cut-off level of detected hemoglobin and decreasing the times of screening [13] , while the introduction of sDNA tests focused on the possibility of the early detection of precancerous lesions [5,14,15,16] .…”

Section: Discussionmentioning

confidence: 99%

TSPAN8 and LGALS4 combination as blood biomarkers for colorectal cancer detection

Rodia¹,

Solmi²,

Lauriola

2016

Cancer Cell Microenviron

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Colorectal cancer (CRC) is the third most common cancer in the world and it is a determinant cause of mortality. A significant survival rate is achieved if the disease is detected at an early stage, thus screening represents an important cancer-control tool. Recently we unveiled a panel of mRNAs, which if isolated in whole blood represent an efficient screening test for colorectal cancer. These mRNA molecules as a biomarker in blood by qRT-PCR assay offer a test with high sensitivity and specificity for clinical diagnostics. The expression of 4 genes: TSPAN8, LGALS4, COL1A2 and CEACAM6 proved to be statistically different between patients and healthy controls. The diagnostic accuracy, in terms of specificity and sensitivity of the TSPAN8 and LGALS4 combination, displayed a sensitivity of 92.5% and a specificity of 67.2%. Our preliminary study was validated on a cohort of 134 subjects and it showed promising results for a prognostic test of blood screening. Nevertheless, it needs to be validated in a larger cohort with stage stratification and in patients with other gastrointestinal diseases.

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Immunochemical faecal occult blood testing to screen for colorectal cancer: can the screening interval be extended?

Abstract: The diagnostic yield of FIT screening using a lowered positivity threshold in combination with an extended screening interval (up to 5 years) may be similar to conventional FIT strategies. This justifies and motivates further research steps in this direction.

Cited by 18 publications

References 17 publications

Fecal occult blood versus DNA testing: indirect comparison in a colorectal cancer screening population

Fecal occult blood versus DNA testing: indirect comparison in a colorectal cancer screening population

Can the performance of a quantitative FIT-based colorectal cancer screening programme be enhanced by lowering the threshold and increasing the interval?

TSPAN8 and LGALS4 combination as blood biomarkers for colorectal cancer detection

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