Fecal immunochemical test-based colorectal cancer screening: The gender dilemma
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Â© 2016, Â© Author(s) 2016. Background: Despite differences between men and women in incidence of colorectal cancer (CRC) and its precursors, screening programs consistently use the same strategy for both genders. Objective: The objective of this article is to illustrate the effects of gender-tailored screening, including the effects on miss rates of advanced neoplasia (AN). Methods: Participants (age 50â€“75 years) in a colonoscopy screening program were asked to complete a fecal immunochemical test (FIT) before colonoscopy. Positivity rates, sensitivity and specificity for detection of AN at multiple cut-offs were determined. Absolute numbers of detected and missed AN per 1000 screenees were calculated. Results: In total 1,256 individuals underwent FIT and colonoscopy, 51% male (median age 61 years; IQR 56â€“66) and 49% female (median age 60 years; IQR 55â€“65). At all cut-offs men had higher positivity rates than women, ranging from 3.8% to 10.8% versus 3.2% to 4.8%. Sensitivity for AN was higher in men than women; 40%â€“25% and 35%â€“22%, respectively. More AN were found and missed in absolute numbers in men at all cut-offs. Conclusion: More AN were both detected and missed in men compared to women at all cut-offs. Gender-tailored cut-offs could either level sensitivity in men and women (i.e., lower cut-off in women) or level the amount of missed lesions (i.e., lower cut-off in men).
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Effects of Increasing Screening Age and Fecal Hemoglobin Cutoff Concentrations in a Colorectal Cancer Screening ProgramWieten, E.; Schreuders, E.; Nieuwenburg, S.; Hansen, B.; Lansdorp_Vogelaar, Iris; Kuipers, E.; Bruno, M.; Spaander, M. (2016)Background & Aims: Several countries have implemented programs to screen for colorectal cancer (CRC) by using the fecal immunochemical test (FIT). These programs vary considerably in age of the population screened and the ...
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Gender Differences in Fecal Immunochemical Test Performance for Early Detection of Colorectal NeoplasiaKapidzic, A.; van der Meulen, M.; Hol, L.; van Roon, A.; Looman, C.; Lansdorp_Vogelaar, Iris; van Ballegooijen, M.; van Vuuren, A.; Reijerink, J.; van Leerdam, M.; Kuipers, E. (2015)Background & Aims: Fecal immunochemical tests (FITs) are used widely in colorectal cancer screening. Programs use the same fecal hemoglobin threshold for colonoscopy referral for men and women, but it is unclear whether ...