Ding Ye1, Qiuchi Huang1, Qilong Li2, Xiyi Jiang1, Mayila Mamat1, Mengling Tang1, Jianbing Wang1, Kun Chen3. 1. Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, 310058, China. 2. Jiashan Institute of Cancer Prevention and Treatment, Jiaxing, 314100, China. 3. Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, 310058, China. ck@zju.edu.cn.
Abstract
BACKGROUND: The fecal immunochemical test (FIT) has been widely used in preliminary screening for colorectal cancer (CRC). The high-risk factor questionnaire (HRFQ) and quantitative risk-assessment method (QRAM) are recommended for estimating the risk of CRC qualitatively and quantitatively in China. AIM: We aimed to prospectively compare the diagnostic values of CRC preliminary screening methods to identify which method is preferable as a screening strategy. METHODS: Individuals aged 40-74 years old were enrolled in a mass CRC screening program from January 1, 2007 to December 31, 2014, in Jiashan County, Zhejiang Province, China. FIT of two stool specimens at 1-week intervals was performed by laboratory personnel and face-to-face interviews were conducted by trained investigators. Screening data in the program were linked to a CRC surveillance and registry system, and CRC cases reported in the system were regarded as true patients. RESULTS: A total of 96,043 subjects were included. The sensitivity and specificity of FIT for detecting CRC cases were 75.49% (95% CI 69.84-80.39) and 90.36% (95% CI 90.17-90.54), respectively. QRAM was more sensitive (p < 0.001) and less specific (p < 0.001) than HRFQ. The sensitivity and specificity of FIT along with HRFQ were 86.56% (95% CI 81.81-90.22) and 81.37% (95% CI 81.12-81.62), and those of FIT along with QRAM were 88.93% (95% CI 84.47-92.23) and 73.95% (95% CI 73.67-74.23). CONCLUSIONS: Our findings suggest that CRC preliminary screening with FIT and QRAM in parallel has high sensitivity and satisfactory specificity, and is a useful strategy in mass screening programs.
BACKGROUND: The fecal immunochemical test (FIT) has been widely used in preliminary screening for colorectal cancer (CRC). The high-risk factor questionnaire (HRFQ) and quantitative risk-assessment method (QRAM) are recommended for estimating the risk of CRC qualitatively and quantitatively in China. AIM: We aimed to prospectively compare the diagnostic values of CRC preliminary screening methods to identify which method is preferable as a screening strategy. METHODS: Individuals aged 40-74 years old were enrolled in a mass CRC screening program from January 1, 2007 to December 31, 2014, in Jiashan County, Zhejiang Province, China. FIT of two stool specimens at 1-week intervals was performed by laboratory personnel and face-to-face interviews were conducted by trained investigators. Screening data in the program were linked to a CRC surveillance and registry system, and CRC cases reported in the system were regarded as true patients. RESULTS: A total of 96,043 subjects were included. The sensitivity and specificity of FIT for detecting CRC cases were 75.49% (95% CI 69.84-80.39) and 90.36% (95% CI 90.17-90.54), respectively. QRAM was more sensitive (p < 0.001) and less specific (p < 0.001) than HRFQ. The sensitivity and specificity of FIT along with HRFQ were 86.56% (95% CI 81.81-90.22) and 81.37% (95% CI 81.12-81.62), and those of FIT along with QRAM were 88.93% (95% CI 84.47-92.23) and 73.95% (95% CI 73.67-74.23). CONCLUSIONS: Our findings suggest that CRC preliminary screening with FIT and QRAM in parallel has high sensitivity and satisfactory specificity, and is a useful strategy in mass screening programs.
Authors: J D Hardcastle; J O Chamberlain; M H Robinson; S M Moss; S S Amar; T W Balfour; P D James; C M Mangham Journal: Lancet Date: 1996-11-30 Impact factor: 79.321
Authors: James E Allison; Lori C Sakoda; Theodore R Levin; Jo P Tucker; Irene S Tekawa; Thomas Cuff; Mary Pat Pauly; Lyle Shlager; Albert M Palitz; Wei K Zhao; J Sanford Schwartz; David F Ransohoff; Joseph V Selby Journal: J Natl Cancer Inst Date: 2007-09-25 Impact factor: 13.506
Authors: Laura C Seeff; Amy DeGroff; Djenaba A Joseph; Janet Royalty; Florence K L Tangka; Marion R Nadel; Marcus Plescia Journal: Cancer Date: 2013-08-01 Impact factor: 6.860
Authors: David P Taylor; Gregory J Stoddard; Randall W Burt; Marc S Williams; Joyce A Mitchell; Peter J Haug; Lisa A Cannon-Albright Journal: Genet Med Date: 2011-05 Impact factor: 8.822
Authors: Wei-Miao Wu; Kai Gu; Yi-Hui Yang; Ping-Ping Bao; Yang-Ming Gong; Yan Shi; Wang-Hong Xu; Chen Fu Journal: Cancer Med Date: 2022-03-11 Impact factor: 4.711