Impact of age- and gender-specific cut-off values for the fecal immunochemical test for hemoglobin in colorectal cancer screening
Por:
Alvarez-Urturi, C, Andreu, M, Hernandez, C, Perez-Riquelme, F, Carballo, F, Ono, A, Cruzado, J, Cubiella, J, Hernandez, V, Gonzalez Mao, C, Perez, E, Salas, D, Andres, M, Bujanda, L, Portillo, I, Sarasqueta, C, Quintero, E, Diego Morillas, J, Lanas, A, Sostres, C, Maria Auge, J, Castells, A, Bessa, X and COLONPREV Study Investigators
Publicada:
1 may 2016
Resumen:
Background: There is no information on the impact of age and gender on
the diagnostic yield of different positivity thresholds for the fecal
immunochemical test for hemoglobin (FIT).
Objectives: To evaluate the performance of this test at distinct
positivity cut-offs in a population -based colorectal cancer (CRC)
screening program.
Methods: CRC detection rate (DR), and analysis of resources were
evaluated retrospectively, at different cut-offs of FIT (20, 25, 30, 35
and 40 tig Hb/g) respect to a reference value (15 tig Hb/g), according
to age and gender, in a screening population of 10,611 participants of
the ColonPrev study (Quintero. NEJM 2013).
Results: At the reference cut-off value, 36 CRC and 252 advanced
adenomas (AA) were diagnosed. Increasing the cut-off in women <60 years
decreases colonoscopies performed by 44.5% without modifying the CRC
(DR). Same CRC DR was observed in men <60 years and women >60 years
increasing cut-off at 25-30 tig Hb/g. In men >60 years, all increases in
the cut-off affected the CRC DR, especially when the cut-off was
increased from 35 to 40 tig Hb/g (CRC miss rate 25%).
Conclusions: To improve the performance of FIT in CRC screening
programs, FIT cut-offs could be individualized by age and gender. (C)
2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier
Ltd. All rights reserved.
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