AIM: To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC) cases from screening and referral cohorts. METHODS: In this comparative observational study, two prospective cohorts of CRC cases were compared. The first cohort was obtained from 10 322 average risk subjects invited for CRC screening with FIT, of which, only subjects with a positive FIT were referred for colonoscopy. The second cohort was obtained from 3637 subjects scheduled for elective colonoscopy with a positive FIT result. The same FIT and positivity threshold (OC sensor; ≥ 50 ng/mL) was used in both cohorts. Colonoscopy was performed in all referral subjects and in FIT positive screening subjects. All CRC cases were selected from both cohorts. Outcome measurements were mean FIT results and FIT scores per tissue tumor stage (T stage). RESULTS: One hundred and eighteen patients with CRC were included in the present study: 28 cases obtained from the screening cohort (64% male; mean age 65 years, SD 6.5) and 90 cases obtained from the referral cohort (58% male; mean age 69 years, SD 9.8). The mean FIT results found were higher in the referral cohort (829 ± 302 ng/mL vs 613 ± 368 ng/mL, P = 0.02). Tissue tumor stage (T stage) distribution was different between both populations [screening population: 13 (46%) T1, eight (29%) T2, six (21%) T3, one (4%) T4 carcinoma; referral population: 12 (13%) T1, 22 (24%) T2, 52 (58%) T3, four (4%) T4 carcinoma], and higher T stage was significantly associated with higher FIT results (P < 0.001). Per tumor stage, no significant difference in mean FIT results was observed (screening vs referral: T1 498 ± 382 ng/mL vs 725 ± 374 ng/mL, P = 0.22; T2 787 ± 303 ng/mL vs 794 ± 341 ng/mL, P = 0.79; T3 563 ± 368 ng/mL vs 870 ± 258 ng/mL, P = 0.13; T4 not available). After correction for T stage in logistic regression analysis, no significant differences in mean FIT results were observed between both types of cohorts (P = 0.10). CONCLUSION: Differences in T stage distribution largely explain differences in FIT results between screening and referral cohorts. Therefore, FIT results should be reported according to T stage.
AIM: To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC) cases from screening and referral cohorts. METHODS: In this comparative observational study, two prospective cohorts of CRC cases were compared. The first cohort was obtained from 10 322 average risk subjects invited for CRC screening with FIT, of which, only subjects with a positive FIT were referred for colonoscopy. The second cohort was obtained from 3637 subjects scheduled for elective colonoscopy with a positive FIT result. The same FIT and positivity threshold (OC sensor; ≥ 50 ng/mL) was used in both cohorts. Colonoscopy was performed in all referral subjects and in FIT positive screening subjects. All CRC cases were selected from both cohorts. Outcome measurements were mean FIT results and FIT scores per tissue tumor stage (T stage). RESULTS: One hundred and eighteen patients with CRC were included in the present study: 28 cases obtained from the screening cohort (64% male; mean age 65 years, SD 6.5) and 90 cases obtained from the referral cohort (58% male; mean age 69 years, SD 9.8). The mean FIT results found were higher in the referral cohort (829 ± 302 ng/mL vs 613 ± 368 ng/mL, P = 0.02). Tissue tumor stage (T stage) distribution was different between both populations [screening population: 13 (46%) T1, eight (29%) T2, six (21%) T3, one (4%) T4 carcinoma; referral population: 12 (13%) T1, 22 (24%) T2, 52 (58%) T3, four (4%) T4 carcinoma], and higher T stage was significantly associated with higher FIT results (P < 0.001). Per tumor stage, no significant difference in mean FIT results was observed (screening vs referral: T1 498 ± 382 ng/mL vs 725 ± 374 ng/mL, P = 0.22; T2 787 ± 303 ng/mL vs 794 ± 341 ng/mL, P = 0.79; T3 563 ± 368 ng/mL vs 870 ± 258 ng/mL, P = 0.13; T4 not available). After correction for T stage in logistic regression analysis, no significant differences in mean FIT results were observed between both types of cohorts (P = 0.10). CONCLUSION: Differences in T stage distribution largely explain differences in FIT results between screening and referral cohorts. Therefore, FIT results should be reported according to T stage.
Authors: Zohar Levi; Paul Rozen; Rachel Hazazi; Alex Vilkin; Amal Waked; Eran Maoz; Shlomo Birkenfeld; Moshe Leshno; Yaron Niv Journal: Ann Intern Med Date: 2007-02-20 Impact factor: 25.391
Authors: P Rozen; Z Levi; R Hazazi; A Waked; A Vilkin; E Maoz; S Birkenfeld; M Leshno; Y Niv Journal: Aliment Pharmacol Ther Date: 2009-04-15 Impact factor: 8.171
Authors: Leo G M van Rossum; Anne F van Rijn; Martijn G H van Oijen; Paul Fockens; Robert J F Laheij; Andre L M Verbeek; Jan B M J Jansen; Evelien Dekker Journal: Int J Cancer Date: 2009-08-15 Impact factor: 7.396
Authors: F A Oort; J S Terhaar Sive Droste; R W M Van Der Hulst; H A Van Heukelem; R J L F Loffeld; I C E Wesdorp; R L J Van Wanrooij; L De Baaij; E R Mutsaers; S van der Reijt; V M H Coupe; J Berkhof; A A Bouman; G A Meijer; C J J Mulder Journal: Aliment Pharmacol Ther Date: 2009-10-29 Impact factor: 8.171
Authors: Leo G van Rossum; Anne F van Rijn; Robert J Laheij; Martijn G van Oijen; Paul Fockens; Han H van Krieken; Andre L Verbeek; Jan B Jansen; Evelien Dekker Journal: Gastroenterology Date: 2008-03-25 Impact factor: 22.682
Authors: L Hol; M E van Leerdam; M van Ballegooijen; A J van Vuuren; H van Dekken; J C I Y Reijerink; A C M van der Togt; J D F Habbema; E J Kuipers Journal: Gut Date: 2010-01 Impact factor: 23.059
Authors: L G M van Rossum; A F van Rijn; I P van Munster; J B M J Jansen; P Fockens; R J F Laheij; E Dekker Journal: Neth J Med Date: 2009-05 Impact factor: 1.422
Authors: L G M van Rossum; A F van Rijn; R J F Laheij; M G H van Oijen; P Fockens; J B M J Jansen; A L M Verbeek; E Dekker Journal: Br J Cancer Date: 2009-09-15 Impact factor: 7.640
Authors: Kevin Selby; Christopher D Jensen; Jeffrey K Lee; Chyke A Doubeni; Joanne E Schottinger; Wei K Zhao; Jessica Chubak; Ethan Halm; Nirupa R Ghai; Richard Contreras; Celette Skinner; Aruna Kamineni; Theodore R Levin; Douglas A Corley Journal: Ann Intern Med Date: 2018-09-18 Impact factor: 25.391
Authors: Sietze T van Turenhout; Frank A Oort; René W M van der Hulst; Arjen P Visscher; Jochim S Terhaar sive Droste; Pieter Scholten; Anneke A Bouman; Gerrit A Meijer; Chris J J Mulder; Leo G M van Rossum; Veerle M H Coupé Journal: BMC Gastroenterol Date: 2014-12-21 Impact factor: 3.067
Authors: Marie Westwood; Shona Lang; Nigel Armstrong; Sietze van Turenhout; Joaquín Cubiella; Lisa Stirk; Isaac Corro Ramos; Marianne Luyendijk; Remziye Zaim; Jos Kleijnen; Callum G Fraser Journal: BMC Med Date: 2017-10-24 Impact factor: 8.775