Influence of Varying Quantitative Fecal Immunochemical Test Positivity Thresholds on Colorectal Cancer Detection: A Community-Based Cohort Study

Annals of Internal Medicine
Kevin SelbyDouglas A Corley

Abstract

The fecal immunochemical test (FIT) is commonly used for colorectal cancer (CRC) screening. Despite demographic variations in stool hemoglobin concentrations, few data exist regarding optimal positivity thresholds by age and sex. To identify programmatic (multitest) FIT performance characteristics and optimal FIT quantitative hemoglobin positivity thresholds in a large, population-based, screening program. Retrospective cohort study. Kaiser Permanente Northern and Southern California. Adults aged 50 to 75 years who were eligible for screening and had baseline quantitative FIT results (2013 to 2014) and 2 years of follow-up. Nearly two thirds (411 241) had FIT screening in the previous 2 years. FIT programmatic sensitivity for CRC and number of positive test results per cancer case detected, overall and by age and sex. Of 640 859 persons who completed a baseline FIT and were followed for 2 years, 481 817 (75%) had at least 1 additional FIT and 1245 (0.19%) received a CRC diagnosis. Cancer detection (programmatic sensitivity) increased at lower positivity thresholds, from 822 in 1245 (66.0%) at 30 µg/g to 925 (74.3%) at 20 µg/g and 987 (79.3%) at 10 µg/g; the number of positive test results per cancer case detected increased from...Continue Reading

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Citations

Sep 23, 2018·Annals of Internal Medicine·Stephen P Halloran
Apr 4, 2019·Acta Oncologica·Geir HoffØyvind Holme
Oct 29, 2019·The American Journal of Gastroenterology·Hermann BrennerKevin Selby
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Sep 17, 2021·BMJ : British Medical Journal·Priyanka Kanth, John M Inadomi

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Methods Mentioned

BETA
452 colonoscopies

Software Mentioned

Sensor Diana
Stata
SEER
SAS
OC

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