Addition of an online, validated family history questionnaire to the Dutch FIT-based screening programme did not improve its diagnostic yield
Open Access
- 20 April 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in British Journal of Cancer
- Vol. 122 (12), 1865-1871
- https://doi.org/10.1038/s41416-020-0832-8
Abstract
Background Faecal immunochemical testing (FIT) is suboptimal in detecting advanced neoplasia (AN). To increase the sensitivity and yield of a FIT-based screening programme, FIT could be combined with risk factors for AN. We evaluated the incremental yield of adding a family history questionnaire (FHQ) on colorectal cancer (CRC) and Lynch syndrome-associated tumours to the Dutch FIT-based screening programme. Methods Six thousand screen-naive individuals, aged 59–75 years, were invited to complete a FIT (FOB-Gold, cut-off 47 µg Hb/g faeces) and a validated online FHQ. Participants with a positive FIT and/or positive FHQ, confirmed after genetic counselling, were referred for colonoscopy. Yield of detecting AN per 1000 invitees for the combined strategy was compared with the FIT-only strategy. Results Of the 5979 invitees, 1952 (32.6%) completed the FIT only, 2379 (39.8%) completed both the FIT and FHQ and 95 (1.6%) completed the FHQ only. Addition of the FHQ to FIT-based screening resulted in one extra case of AN detected after 16 additional colonoscopies, resulting in a yield of 19.6 (95% CI, 16.4–23.5) for the combined strategy versus 19.5 (95% CI, 16.3–23.3) for the FIT-only strategy (p = 1.0). Conclusions The addition of an FHQ to one round of FIT screening did not increase the detection of AN compared with FIT only (ClinicalTrials.gov NCT02698462).Keywords
Funding Information
- Maag Lever Darm Stichting (TC 12-05)
This publication has 29 references indexed in Scilit:
- Diagnostic accuracy of faecal immunochemical test for screening individuals with a family history of colorectal cancerAlimentary Pharmacology & Therapeutics, 2013
- First-Degree Relatives of Colorectal Cancer Patients Are Likely to Show Advanced Colorectal Neoplasia despite a Negative Fecal Immunochemical TestDigestion, 2012
- Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer DeathsThe New England Journal of Medicine, 2012
- Colonoscopic findings in first-degree relatives of patients with colorectal cancer: a population-based screening programGastrointestinal Endoscopy, 2011
- The Search for Unaffected Individuals with Lynch Syndrome: Do the Ends Justify the Means?Cancer Prevention Research, 2011
- Hereditary and Familial Colon CancerGastroenterology, 2010
- Family history? The forgotten question in high‐risk colorectal cancer patientsColorectal Disease, 2009
- Many participants in fecal occult blood test population screening have a higher-than-average risk for colorectal cancerEuropean Journal of Gastroenterology & Hepatology, 2006
- Why patients do not attend for their appointments at a genetics clinicJournal of Medical Genetics, 2000
- Genetic Alterations during Colorectal-Tumor DevelopmentThe New England Journal of Medicine, 1988