Fecal immunochemical test-based colorectal cancer screening: The gender dilemma

© 2016, © Author(s) 2016. Background: Despite differences between men and women in incidence of colorectal cancer (CRC) and its precursors, screening programs consistently use the same strategy for both genders. Objective: The objective of this article is to illustrate the effects of gender-tailor...

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Main Authors: Grobbee, E., Wieten, E., Hansen, B., Stoop, E., de Wijkerslooth, T., Lansdorp-Vogelaar, Iris, Bossuyt, P., Dekker, E., Kuipers, E., Spaander, M.
Format: Journal Article
Published: 2017
Online Access:http://hdl.handle.net/20.500.11937/63098
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author Grobbee, E.
Wieten, E.
Hansen, B.
Stoop, E.
de Wijkerslooth, T.
Lansdorp-Vogelaar, Iris
Bossuyt, P.
Dekker, E.
Kuipers, E.
Spaander, M.
author_facet Grobbee, E.
Wieten, E.
Hansen, B.
Stoop, E.
de Wijkerslooth, T.
Lansdorp-Vogelaar, Iris
Bossuyt, P.
Dekker, E.
Kuipers, E.
Spaander, M.
author_sort Grobbee, E.
building Curtin Institutional Repository
collection Online Access
description © 2016, © Author(s) 2016. Background: Despite differences between men and women in incidence of colorectal cancer (CRC) and its precursors, screening programs consistently use the same strategy for both genders. Objective: The objective of this article is to illustrate the effects of gender-tailored screening, including the effects on miss rates of advanced neoplasia (AN). Methods: Participants (age 50–75 years) in a colonoscopy screening program were asked to complete a fecal immunochemical test (FIT) before colonoscopy. Positivity rates, sensitivity and specificity for detection of AN at multiple cut-offs were determined. Absolute numbers of detected and missed AN per 1000 screenees were calculated. Results: In total 1,256 individuals underwent FIT and colonoscopy, 51% male (median age 61 years; IQR 56–66) and 49% female (median age 60 years; IQR 55–65). At all cut-offs men had higher positivity rates than women, ranging from 3.8% to 10.8% versus 3.2% to 4.8%. Sensitivity for AN was higher in men than women; 40%–25% and 35%–22%, respectively. More AN were found and missed in absolute numbers in men at all cut-offs. Conclusion: More AN were both detected and missed in men compared to women at all cut-offs. Gender-tailored cut-offs could either level sensitivity in men and women (i.e., lower cut-off in women) or level the amount of missed lesions (i.e., lower cut-off in men).
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spelling curtin-20.500.11937-630982018-02-06T06:23:10Z Fecal immunochemical test-based colorectal cancer screening: The gender dilemma Grobbee, E. Wieten, E. Hansen, B. Stoop, E. de Wijkerslooth, T. Lansdorp-Vogelaar, Iris Bossuyt, P. Dekker, E. Kuipers, E. Spaander, M. © 2016, © Author(s) 2016. Background: Despite differences between men and women in incidence of colorectal cancer (CRC) and its precursors, screening programs consistently use the same strategy for both genders. Objective: The objective of this article is to illustrate the effects of gender-tailored screening, including the effects on miss rates of advanced neoplasia (AN). Methods: Participants (age 50–75 years) in a colonoscopy screening program were asked to complete a fecal immunochemical test (FIT) before colonoscopy. Positivity rates, sensitivity and specificity for detection of AN at multiple cut-offs were determined. Absolute numbers of detected and missed AN per 1000 screenees were calculated. Results: In total 1,256 individuals underwent FIT and colonoscopy, 51% male (median age 61 years; IQR 56–66) and 49% female (median age 60 years; IQR 55–65). At all cut-offs men had higher positivity rates than women, ranging from 3.8% to 10.8% versus 3.2% to 4.8%. Sensitivity for AN was higher in men than women; 40%–25% and 35%–22%, respectively. More AN were found and missed in absolute numbers in men at all cut-offs. Conclusion: More AN were both detected and missed in men compared to women at all cut-offs. Gender-tailored cut-offs could either level sensitivity in men and women (i.e., lower cut-off in women) or level the amount of missed lesions (i.e., lower cut-off in men). 2017 Journal Article http://hdl.handle.net/20.500.11937/63098 10.1177/2050640616659998 unknown
spellingShingle Grobbee, E.
Wieten, E.
Hansen, B.
Stoop, E.
de Wijkerslooth, T.
Lansdorp-Vogelaar, Iris
Bossuyt, P.
Dekker, E.
Kuipers, E.
Spaander, M.
Fecal immunochemical test-based colorectal cancer screening: The gender dilemma
title Fecal immunochemical test-based colorectal cancer screening: The gender dilemma
title_full Fecal immunochemical test-based colorectal cancer screening: The gender dilemma
title_fullStr Fecal immunochemical test-based colorectal cancer screening: The gender dilemma
title_full_unstemmed Fecal immunochemical test-based colorectal cancer screening: The gender dilemma
title_short Fecal immunochemical test-based colorectal cancer screening: The gender dilemma
title_sort fecal immunochemical test-based colorectal cancer screening: the gender dilemma
url http://hdl.handle.net/20.500.11937/63098