Immunochemical faecal occult blood testing to screen for colorectal cancer: Can the screening interval be extended?
Access Status
Authors
Date
2016Type
Metadata
Show full item recordCitation
Source Title
ISSN
Collection
Abstract
Objective: Colorectal cancer (CRC) screening programmes based on faecal immunochemical testing for haemoglobin (FIT) typically use a screening interval of 2 years. We aimed to estimate how alternative FIT strategies that use a lower than usual positivity threshold followed by a longer screening interval compare with conventional strategies. Methods: We analysed longitudinal data of 4523 Dutch individuals (50-74 years at baseline) participating in round I of a one-sample FIT screening programme, of which 3427 individuals also participated in round II after 1-3 years. The cohort was followed until 2 years after round II. In both rounds, a cut-off level of =50 ng haemoglobin (Hb)/mL buffer (corresponding to 10 mg Hb/g faeces) was used, representing the standard scenario. We determined the cumulative positivity rate (PR) and the numbers of subjects diagnosed with advanced adenomas (N_AdvAd) and early stage CRC (N_earlyCRC) in the cohort over two rounds of screening (standard scenario) and compared it with hypothetical single-round screening with use of a lower cut-off and omission of the second round (alternative scenario). Results: In the standard scenario, the cumulative (ie, round I and II combined) PR, N_AdvAd and N_earlyCRC were 13%, 180% and 26%, respectively. In alternative scenarios using a cut-off level of respectively =11 and =22 ng/HbmL buffer (corresponding to 2 and 4 mg Hb/g faeces), the PRs were 18% and 13%, the N_AdvAd were 180 and 162 and the N_earlyCRC ranged between 22-27 and 22-26. Conclusions: 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.
Related items
Showing items related by title, author, creator and subject.
-
van der Vlugt, M.; Grobbee, E.; Bossuyt, P.; Bos, A.; Bongers, E.; Spijker, W.; Kuipers, E.; Lansdorp_Vogelaar, Iris; Spaander, M.; Dekker, E. (2017)© 2017 AGA Institute Background & Aims Among subjects screened for colorectal cancer (CRC) by the guaiac fecal occult blood test, interval cancers develop in 48% to 55% of the subjects. Data are limited on how many ...
-
Goede, S.; Van Roon, A.; Reijerink, J.; Van Vuuren, A.; Lansdorp_Vogelaar, Iris; Habbema, J.; Kuipers, E.; Van Leerdam, M.; Van Ballegooijen, M. (2013)Objective The sensitivity and specificity of a single faecal immunochemical test (FIT) are limited. The performance of FIT screening can be improved by increasing the screening frequency or by providing more than one ...
-
Vanness, D.; Knudsen, A.; Lansdorp_Vogelaar, Iris; Rutter, C.; Gareen, I.; Herman, B.; Kuntz, K.; Zauber, A.; Van Ballegooijen, M.; Feuer, E.; Chen, M.; Johnson, C. (2011)Purpose: To estimate the cost-effectiveness of computed tomographic (CT) colonography for colorectal cancer (CRC) screening in average-risk asymptomatic subjects in the United States aged 50 years. Materials and Methods: ...