Faecal haemoglobin concentrations by gender and age: implications for population-based screening for colorectal cancer
- 7 December 2011
- journal article
- research article
- Published by Walter de Gruyter GmbH in cclm
- Vol. 50 (5), 935-940
- https://doi.org/10.1515/cclm.2011.815
Abstract
Faecal immunochemical tests (FIT) are becoming widely used in colorectal cancer screening. Estimation of faecal haemoglobin concentration in a large group prompted an observational study on gender and age.A single estimate of faecal haemoglobin concentration was made using quantitative automated immunoturbidimetry. Potential reference intervals were calculated for men and women and for age quintiles according to the Clinical and Laboratory Standards Institute Approved Guideline. The percentages of positive results were calculated at a number of concentrations. The percentages of individuals who fell into different risk groups were assessed.The 97.5 percentiles, potential upper reference limits, were 519 ng haemoglobin/mL (90% CI: 468–575) for men and 283 ng haemoglobin/mL (90% CI: 257–316) for women. Concentrations increased with age in both genders. Decision limits have advantages over reference intervals. At any cut-off concentration, more men are declared positive than women and more older people are declared positive than younger people. Future risk of neoplasia is higher in men than in women and in older people.Faecal haemoglobin concentrations vary with gender and age. More tailored strategies are needed in screening programmes. Faecal haemoglobin concentration could be included in individual risk assessment scores. These data should assist in screening programme design.Keywords
This publication has 18 references indexed in Scilit:
- High Yield of Colorectal Neoplasia Detected by Colonoscopy following a Positive Faecal Occult Blood Test in the Nhs Bowel Cancer Screening ProgrammeJournal of Medical Screening, 2011
- Sex Differences in Performance of Fecal Occult Blood TestingAmerican Journal of Gastroenterology, 2010
- Use of faecal markers in screening for colorectal neoplasia: a European group on tumor markers position paperInternational Journal of Cancer, 2010
- Effect of Gender, Age and Deprivation on Key Performance Indicators in a Fobt-based Colorectal Screening ProgrammeJournal of Medical Screening, 2010
- Contrasting US and European approaches to colorectal cancer screening: which is best?Gut, 2010
- Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancerGut, 2008
- French colorectal cancer screening pilot programme: results of the first roundJournal of Medical Screening, 2008
- Automated immunochemical quantitation of haemoglobin in faeces collected on cards for screening for colorectal cancerGut, 2008
- Association of FOBT-assessed faecal Hb content with colonic lesions detected in the Florence screening programmeBritish Journal of Cancer, 2007
- A systematic review of the effects of screening for colorectal cancer using the faecal occult blood test, HemoccultBMJ, 1998