Evaluation of the effectiveness of qualitative and quantitative fecal immunochemical tests in colorectal cancer screening
Objective To compare the effectiveness of qualitative and quantitative fecal immunochemical tests(FIT)in identifying colorectal cancer,so as to provide insights into perfecting screening strategies for colorectal cancer.Methods Participants in the Colorectal Cancer Screening Program for Key Populations in Zhejiang Province from May 2020 to De-cember 2021 were recruited,and their demographic information,lifestyle and disease history were collected through a questionnaire survey.Qualitative or quantitative FIT along with a questionnaire-based risk assessment were employed as the initial screening tests.Individuals who were positive in any FIT or had high-risk assessment results were required to attend a subsequent colonoscopy examination.The positive rate,detection rate of colorectal cancer,positive predictive value and number of colonoscopies required were compared between qualitative and quantitative FITs,and stratified anal-yses by gender and age were conducted.Results Totally 4 099 769 participants were included.The qualitative FIT group included 3 574 917 individuals,yielding a positive rate of 11.35%,a detection rate of 1.19%,a positive predic-tive value of 0.48%and 83.84 colonoscopies required to detect one cancer case.The quantitative FIT group involved 524 852 individuals,yielding a positive rate of 6.70%,a detection rate of 2.31%,a positive predictive value of 1.01%and 43.23 colonoscopies required to detect one cancer case.The quantitative FIT group showed significantly higher de-tection rate of colorectal cancer,higher positive predictive value and less number of colonoscopies required compared to the qualitative FIT group(all P＜0.05).The same results were obtained after stratification by gender and age.Conclu-sion Compared to qualitative FIT,quantitative FIT improves the detection of colorectal cancer and reduces the work-load of colonoscopy examinations,making it more suitable for colorectal cancer screening in large-scale populations.
colorectal cancer screeningqualitative fecal immunochemical testquantitative fecal immunochemical test
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