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

United European Gastroenterology Journal
Esmée J GrobbeeManon C W Spaander

Abstract

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. The objective of this article is to illustrate the effects of gender-tailored screening, including the effects on miss rates of advanced neoplasia (AN). 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. 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. 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 wo...Continue Reading

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Citations

Aug 14, 2018·Cancer Medicine·Carrie M NielsonGloria D Coronado
Sep 16, 2020·Journal of Internal Medicine·R Hultcrantz
Mar 5, 2020·Journal of General Internal Medicine·Vivy T Cusumano, Folasade P May
Jan 29, 2020·European Journal of Gastroenterology & Hepatology·Ulrike Haug, Veerle M H Coupé
May 14, 2021·International Journal of Colorectal Disease·M J Domper ArnalA Lanas
May 19, 2021·JAMA : the Journal of the American Medical Association·Jennifer S LinPaula R Blasi
May 16, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Subashini ChandrapalanRamesh P Arasaradnam

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