Immunochemical faecal occult blood test: number of samples and positivity cutoff. What is the best strategy for colorectal cancer screening?
Open Access
- 13 January 2009
- journal article
- research article
- Published by Springer Science and Business Media LLC in British Journal of Cancer
- Vol. 100 (2), 259-265
- https://doi.org/10.1038/sj.bjc.6604864
Abstract
Immunochemical faecal occult blood tests have shown a greater sensitivity than guaiac test in colorectal cancer screening, but optimal number of samples and cutoff have still to be defined. The aim of this multicentric study was to evaluate the performance of immunochemical-based screening strategies according to different positivity thresholds (80, 100, 120 ng ml−1) and single vs double sampling (one, at least one, or both positive samples) using 1-day sample with cutoff at 100 ng ml−1 as the reference strategy. A total of 20 596 subjects aged 50–69 years were enrolled from Italian population-based screening programmes. Positivity rate was 4.5% for reference strategy and 8.0 and 2.0% for the most sensitive and the most specific strategy, respectively. Cancer detection rate of reference strategy was 2.8‰, and ranged between 2.1 and 3.4‰ in other strategies; reference strategy detected 15.6‰ advanced adenomas (range=10.0–22.5‰). The number needed to scope to find a cancer or an advanced adenoma was lower than 2 (1.5–1.7) for the most specific strategies, whereas it was 2.4–2.7, according to different thresholds, for the most sensitive ones. Different strategies seem to have a greater impact on adenomas rather than on cancer detection rate. The study provides information when deciding screening protocols and to adapt them to local resources.Keywords
This publication has 26 references indexed in Scilit:
- Screening for colorectal cancer in Italy: 2006 survey.2008
- Screening, Surveillance, and Primary Prevention for Colorectal Cancer: A Review of the Recent LiteratureGastroenterology, 2008
- Random Comparison of Guaiac and Immunochemical Fecal Occult Blood Tests for Colorectal Cancer in a Screening PopulationGastroenterology, 2008
- A Quantitative Immunochemical Fecal Occult Blood Test for Colorectal NeoplasiaAnnals of Internal Medicine, 2007
- Estimates of the cancer incidence and mortality in Europe in 2006Annals Of Oncology, 2007
- Comparison of a guaiac based and an immunochemical faecal occult blood test in screening for colorectal cancer in a general average risk populationGut, 2007
- Screening for colorectal cancer using the faecal occult blood test, HemoccultCochrane Database of Systematic Reviews, 2007
- Screening for colorectal cancer using faecal blood testing: varying the positive cut-off valuePathology, 2005
- Results of the first round of a demonstration pilot of screening for colorectal cancer in the United KingdomBMJ, 2004
- Screening for colorectal cancer using the faecal occult blood test, HemoccultPublished by Wiley ,1998