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. 2014 Dec;2(6):522-9.
doi: 10.1177/2050640614553285.

Diagnostic accuracy of fecal immunochemical test in average- and familial-risk colorectal cancer screening

Joaquín Cubiella  1 , Inés Castro  1 , Vicent Hernandez  2 , Carmen González-Mao  3 , Concepción Rivera  1 , Felipe Iglesias  4 , María Teresa Alves  5 , Lucía Cid  2 , Santiago Soto  1 , Luisa De-Castro  2 , Pablo Vega  1 , Jose Antonio Hermo  2 , Ramiro Macenlle  1 , Alfonso Martínez  2 , Pamela Estevez  2 , Estela Cid  1 , Marta Herreros-Villanueva  6 , Isabel Portillo  7 , Luis Bujanda  7 , Javier Fernández-Seara  1 ; COLONPREV study investigators
Affiliations

Diagnostic accuracy of fecal immunochemical test in average- and familial-risk colorectal cancer screening

Joaquín Cubiella et al. United European Gastroenterol J. 2014 Dec.

Abstract

Background: There is little information about the fecal immunochemical test (FIT) in familial-risk colorectal cancer (CRC) screening.

Objectives: The objective of this article is to investigate whether FIT diagnostic accuracy for advanced neoplasia (AN) differs between average and familial-risk (first-degree relative) patients.

Methods: A total of 1317 consecutive participants (595 familial) who collected one stool sample before performing a colonoscopy as a CRC screening test were included. FIT diagnostic accuracy for AN was evaluated with Chi-square test at a 20 µg hemoglobin/g of feces cut-off value. Finally, we determined which variables were independently related to AN.

Results: An AN was found in 151 (11.5%) patients. The overall accuracy was not statistically different between both cohorts for AN (88.4%, 91.7%; p = 0.051). At the cut-off stablished, differences in FIT sensitivity (31.1%, 40.6%; p = 0.2) or specificity (96.5%, 97.3%; p = 0.1) were not statistically significant. Finally, independent variables such as sex (male) (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.4-3.1), age (50-65, >65 years) (OR 2.1, 95% CI 1.1-4.3; OR 2.7, 95% CI 1.2-6.1), previous colonoscopy (OR 0.4, 95% CI 0.2-0.9) and FIT ≥20 µg/g feces (OR 17.7, 95% CI 10.8-29.1) were associated with AN diagnosis.

Conclusions: FIT accuracy for AN detection is equivalent in average and familial-risk CRC screening cohorts.

Keywords: Colorectal cancer; colonoscopy; colorectal adenoma; colorectal cancer screening; familial colorectal cancer; fecal immunochemical test; sensitivity and specificity.

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Figures

Figure 1.
Figure 1.
Enrollment of individuals included in the study. CRC: colorectal cancer; FDR: first-degree relative; FIT: fecal immunochemical test.
Figure 2.
Figure 2.
Receiver-operating characteristics (ROC) curves of fecal immunochemical test in average-risk and familial-risk cohorts for the detection of advanced neoplasia. The areas under the curve (AUC) of the ROC curves are compared with the homogeneity area test. Std.Err: standard error.
See this image and copyright information in PMC

References

    1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010; 127: 2893–2917. - PubMed
    1. Hewitson P, Glasziou P, Watson E, et al. Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (hemoccult): An update. Am J Gastroenterol 2008; 103: 1541–1549. - PubMed
    1. Mandel JS, Church TR, Bond JH, et al. The effect of fecal occult-blood screening on the incidence of colorectal cancer. N Engl J Med 2000; 343: 1603–1607. - PubMed
    1. Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: A joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology 2008; 134: 1570–1595. - PubMed
    1. Atkin WS, Edwards R, Kralj-Hans I, et al. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: A multicentre randomised controlled trial. Lancet 2010; 375: 1624–1633. - PubMed