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

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    Fulltext not available
    Authors
    Haug, U.
    Grobbee, E.
    Lansdorp-Vogelaar, Iris
    Spaander, M.
    Kuipers, E.
    Date
    2016
    Type
    Journal Article
    
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    Citation
    Haug, U. and Grobbee, E. and Lansdorp-Vogelaar, I. and Spaander, M. and Kuipers, E. 2016. Immunochemical faecal occult blood testing to screen for colorectal cancer: Can the screening interval be extended? Gut. 66 (7): pp. 1262-1267.
    Source Title
    Gut
    DOI
    10.1136/gutjnl-2015-310102
    ISSN
    0017-5749
    URI
    http://hdl.handle.net/20.500.11937/50176
    Collection
    • Curtin Research Publications
    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.

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