Amber L Crouse, Lawrence De Koning, S M Hossein Sadrzadeh, Christopher Naugler1. 1. From Calgary Laboratory Services, Calgary, Alberta, Canada (Ms Crouse and Drs Koning, Sadrzadeh, and Naugler); and the Departments of Pathology and Laboratory Medicine (Ms Crouse and Drs Koning, Sadrzadeh, and Naugler) and Family Medicine (Dr Naugler), University of Calgary, Calgary, Alberta, Canada.
Abstract
CONTEXT: Community-based programs are a common way of promoting colorectal cancer screening by primary care physicians. Fecal immunochemical testing (FIT) is a screening method commonly used in such programs. Fecal immunochemical testing has advantages to the patient as well as to clinical laboratories. OBJECTIVE: To assess the operational test characteristics of a FIT pilot program in Calgary, Alberta, Canada, between April 2011 and May 2012. DESIGN: Four hundred fifty-seven high-risk patients undergoing both FIT and colonoscopy were included. Areas under the curve and positive predictive values were derived for FIT values and biopsy-proven neoplasia. Subgroup analysis was also performed on men and women and for ages older and younger than the mean age of 62 years. RESULTS: For colorectal carcinoma and colonic adenomas the areas under the curve were 0.79 (95% confidence interval 0.71-0.87) and 0.60 (95% confidence interval 0.54-0.65), respectively. The positive predictive value of a positive FIT result for any neoplasia was 53%. The overall performance of the test for all neoplasia was better for men and better for older individuals. CONCLUSIONS: The performance of FIT in this clinical setting was very good for detecting carcinoma, but marginal for detection of colonic adenomas.
CONTEXT: Community-based programs are a common way of promoting colorectal cancer screening by primary care physicians. Fecal immunochemical testing (FIT) is a screening method commonly used in such programs. Fecal immunochemical testing has advantages to the patient as well as to clinical laboratories. OBJECTIVE: To assess the operational test characteristics of a FIT pilot program in Calgary, Alberta, Canada, between April 2011 and May 2012. DESIGN: Four hundred fifty-seven high-risk patients undergoing both FIT and colonoscopy were included. Areas under the curve and positive predictive values were derived for FIT values and biopsy-proven neoplasia. Subgroup analysis was also performed on men and women and for ages older and younger than the mean age of 62 years. RESULTS: For colorectal carcinoma and colonic adenomas the areas under the curve were 0.79 (95% confidence interval 0.71-0.87) and 0.60 (95% confidence interval 0.54-0.65), respectively. The positive predictive value of a positive FIT result for any neoplasia was 53%. The overall performance of the test for all neoplasia was better for men and better for older individuals. CONCLUSIONS: The performance of FIT in this clinical setting was very good for detecting carcinoma, but marginal for detection of colonic adenomas.
Authors: Rachel B Issaka; Maneesh H Singh; Sachiko M Oshima; Victoria J Laleau; Carly D Rachocki; Ellen H Chen; Lukejohn W Day; Urmimala Sarkar; Ma Somsouk Journal: Am J Gastroenterol Date: 2016-12-13 Impact factor: 10.864
Authors: Barcey T Levy; Jeanette M Daly; Yinghui Xu; Seth D Crockett; Richard M Hoffman; Jeffrey D Dawson; Kim Parang; Navkiran K Shokar; Daniel S Reuland; Marc J Zuckerman; Avraham Levin Journal: Contemp Clin Trials Date: 2021-05-08 Impact factor: 2.261