Immunochemical faecal occult blood testing to screen for colorectal cancer: Can the screening interval be extended?
Objective: Colorectal cancer (CRC) screening programmes based on faecal immunochemical testing for haemoglobin (FIT) typically use a screening interval of 2 years. We aimed to estimate how alternative FIT strategies that use a lower than usual positivity threshold followed by a longer screening inte...
| Main Authors: | , , , , |
|---|---|
| Format: | Journal Article |
| Published: |
2016
|
| Online Access: | http://hdl.handle.net/20.500.11937/50176 |
| _version_ | 1848758413264158720 |
|---|---|
| author | Haug, U. Grobbee, E. Lansdorp-Vogelaar, Iris Spaander, M. Kuipers, E. |
| author_facet | Haug, U. Grobbee, E. Lansdorp-Vogelaar, Iris Spaander, M. Kuipers, E. |
| author_sort | Haug, U. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: Colorectal cancer (CRC) screening programmes based on faecal immunochemical testing for haemoglobin (FIT) typically use a screening interval of 2 years. We aimed to estimate how alternative FIT strategies that use a lower than usual positivity threshold followed by a longer screening interval compare with conventional strategies. Methods: We analysed longitudinal data of 4523 Dutch individuals (50-74 years at baseline) participating in round I of a one-sample FIT screening programme, of which 3427 individuals also participated in round II after 1-3 years. The cohort was followed until 2 years after round II. In both rounds, a cut-off level of =50 ng haemoglobin (Hb)/mL buffer (corresponding to 10 mg Hb/g faeces) was used, representing the standard scenario. We determined the cumulative positivity rate (PR) and the numbers of subjects diagnosed with advanced adenomas (N_AdvAd) and early stage CRC (N_earlyCRC) in the cohort over two rounds of screening (standard scenario) and compared it with hypothetical single-round screening with use of a lower cut-off and omission of the second round (alternative scenario). Results: In the standard scenario, the cumulative (ie, round I and II combined) PR, N_AdvAd and N_earlyCRC were 13%, 180% and 26%, respectively. In alternative scenarios using a cut-off level of respectively =11 and =22 ng/HbmL buffer (corresponding to 2 and 4 mg Hb/g faeces), the PRs were 18% and 13%, the N_AdvAd were 180 and 162 and the N_earlyCRC ranged between 22-27 and 22-26. Conclusions: The diagnostic yield of FIT screening using a lowered positivity threshold in combination with an extended screening interval (up to 5 years) may be similar to conventional FIT strategies. This justifies and motivates further research steps in this direction. |
| first_indexed | 2025-11-14T09:43:35Z |
| format | Journal Article |
| id | curtin-20.500.11937-50176 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T09:43:35Z |
| publishDate | 2016 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-501762017-09-13T16:09:22Z Immunochemical faecal occult blood testing to screen for colorectal cancer: Can the screening interval be extended? Haug, U. Grobbee, E. Lansdorp-Vogelaar, Iris Spaander, M. Kuipers, E. Objective: Colorectal cancer (CRC) screening programmes based on faecal immunochemical testing for haemoglobin (FIT) typically use a screening interval of 2 years. We aimed to estimate how alternative FIT strategies that use a lower than usual positivity threshold followed by a longer screening interval compare with conventional strategies. Methods: We analysed longitudinal data of 4523 Dutch individuals (50-74 years at baseline) participating in round I of a one-sample FIT screening programme, of which 3427 individuals also participated in round II after 1-3 years. The cohort was followed until 2 years after round II. In both rounds, a cut-off level of =50 ng haemoglobin (Hb)/mL buffer (corresponding to 10 mg Hb/g faeces) was used, representing the standard scenario. We determined the cumulative positivity rate (PR) and the numbers of subjects diagnosed with advanced adenomas (N_AdvAd) and early stage CRC (N_earlyCRC) in the cohort over two rounds of screening (standard scenario) and compared it with hypothetical single-round screening with use of a lower cut-off and omission of the second round (alternative scenario). Results: In the standard scenario, the cumulative (ie, round I and II combined) PR, N_AdvAd and N_earlyCRC were 13%, 180% and 26%, respectively. In alternative scenarios using a cut-off level of respectively =11 and =22 ng/HbmL buffer (corresponding to 2 and 4 mg Hb/g faeces), the PRs were 18% and 13%, the N_AdvAd were 180 and 162 and the N_earlyCRC ranged between 22-27 and 22-26. Conclusions: The diagnostic yield of FIT screening using a lowered positivity threshold in combination with an extended screening interval (up to 5 years) may be similar to conventional FIT strategies. This justifies and motivates further research steps in this direction. 2016 Journal Article http://hdl.handle.net/20.500.11937/50176 10.1136/gutjnl-2015-310102 restricted |
| spellingShingle | Haug, U. Grobbee, E. Lansdorp-Vogelaar, Iris Spaander, M. Kuipers, E. Immunochemical faecal occult blood testing to screen for colorectal cancer: Can the screening interval be extended? |
| title | Immunochemical faecal occult blood testing to screen for colorectal cancer: Can the screening interval be extended? |
| title_full | Immunochemical faecal occult blood testing to screen for colorectal cancer: Can the screening interval be extended? |
| title_fullStr | Immunochemical faecal occult blood testing to screen for colorectal cancer: Can the screening interval be extended? |
| title_full_unstemmed | Immunochemical faecal occult blood testing to screen for colorectal cancer: Can the screening interval be extended? |
| title_short | Immunochemical faecal occult blood testing to screen for colorectal cancer: Can the screening interval be extended? |
| title_sort | immunochemical faecal occult blood testing to screen for colorectal cancer: can the screening interval be extended? |
| url | http://hdl.handle.net/20.500.11937/50176 |