首页|Similar fecal immunochemical test results in screening and referral colorectal cancer

Similar fecal immunochemical test results in screening and referral colorectal cancer

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AIM:To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC)cases from screening and referral cohorts.METHODS:In this comparative observational study,two prospective cohorts of CRC cases were compared.The first cohort was obtained from 10 322 average risk subjects invited for CRC screening with FIT,of which,only subjects with a positive FIT were referred for colonoscopy.The second cohort was obtained from 3637subjects scheduled for elective colonoscopy with a positive FIT result.The same FIT and positivity threshold (OC sensor; ≥ 50 ng/mL) was used in both cohorts.Colonoscopy was performed in all referral subjects and in FIT positive screening subjects.All CRC cases were selected from both cohorts.Outcome measurements were mean FIT results and FIT scores per tissue tumor stage (T stage).RESULTS:One hundred and eighteen patients with CRC were included in the present study:28 cases obtained from the screening cohort (64% male; mean age 65 years,SD 6.5) and 90 cases obtained from the referral cohort (58% male; mean age 69 years,SD 9.8).The mean FIT results found were higher in the referral cohort (829 ± 302 ng/mL vs 613 ± 368 ng/mL,P =0.02).Tissue tumor stage (T stage) distribution was different between both populations [screening population:13 (46%) T1,eight (29%) T2,six (21%) T3,one (4%)T4 carcinoma; referral population:12 (13%) T1,22(24%) T2,52 (58%) T3,four (4%) T4 carcinoma],and higher T stage was significantly associated with higher FIT results (P < 0.001).Per tumor stage,no significant difference in mean F1T results was observed (screening vs referral:T1 498 ± 382 ng/mL vs 725 ± 374 ng/mL,P =0.22; T2 787 ± 303 ng/mL vs 794 ± 341 ng/mL,P=0.79; T3 563 ± 368 ng/mL vs 870 ± 258 ng/mL,P =0.13; T4 not available).Alter correction for T stage in logistic regression analysis,no significant differences in mean FIT results were observed between both types of cohorts (P =0.10).CONCLUSION:Differences in T stage distribution largely explain differences in FIT results between screening and referral cohorts.Therefore,FIT results should be reported according to T stage.

Screening populationReferral cohortFecal immunochemical testTumor stage distributionColorectal cancer

Sietze T van Turenhout、Leo GM van Rossum、Frank A Oort、Robert JF Laheij、Anne F van Rijn、Jochim S Terhaar sive Droste、Paul Fockens

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Department of Gastroenterology and Hepatology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands

Department of Epidemiology Biostatistics and HTA, Radboud University Nijmegen Medical Center, 6500HB Nijmegen, The Netherlands

Department of Gastroenterology and Hepatology, Radboud University Nijmegen Medical Center, 6500 HB Nijmegen, The Netherlands

Department of Gastroenterology and Hepatology, Academic Medical Center,1105 AZ Amsterdam, The Netherlands

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A Research Grant of Center for Translational Molecular MedicineNetherlands,to van Turenhout STHoofddorp to "the Amsterdam Gut-club"NetherlandsNetherlands Organization for Health Research and Development,ZonMWNetherlands Organization for Health Research and Development,ZonMWoriginal trial was registered Current Controlled Trials

50-50115-98-06063000004ISRCTN57917442

2012

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子:1.001
ISSN:1007-9327
年,卷(期):2012.18(38)
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