scholarly journals Feasibility and performance of the fecal immunochemical test (FIT) for average-risk colorectal cancer screening in Nigeria

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0243587
Author(s):  
Gregory C. Knapp ◽  
Olusegun Alatise ◽  
Bolatito Olopade ◽  
Marguerite Samson ◽  
Olalekan Olasehinde ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Intestinal Parasites ◽  
Exploratory Analysis ◽  
Fecal Immunochemical Test ◽  
Sub Saharan Africa ◽  
Average Risk ◽  
Crc Screening ◽  
Immunochemical Test ◽  
And Performance

Introduction There is a paucity of prospective data on the performance of the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening in sub-Saharan Africa. The aim of this exploratory analysis was to evaluate the feasibility and performance of FIT in Nigeria. Methods This was a prospective, single-arm study. A convenience sample of asymptomatic, average-risk individuals between 40–75 years of age were enrolled at Obafemi Awolowo University Teaching Hospital. Study participants returned in 48 hours with a specimen for ova and parasite (O&P) and qualitative FIT (50ug/g) testing. Participants with a positive FIT had follow-up colonoscopy and those with intestinal parasites were provided treatment. Results Between May-June 2019, 379 individuals enrolled with a median age of 51 years (IQR 46–58). In total, 87.6% (n = 332) returned for FIT testing. FIT positivity was 20.5% (95% CI = 16.3%-25.2%). Sixty-one (89.7%) of participants with a positive FIT had a follow-up colonoscopy (n = 61), of whom 9.8% (95%CI:3.7–20.2%) had an adenoma and 4.9% (95%CI:1.0–13.7%) had advanced adenomas. Presence of intestinal parasites was inversely related to FIT positivity (6.5% with vs. 21.1% without parasites, p = 0.05). Eighty-two percent of participants found the FIT easy to use and 100% would recommend the test to eligible family or friends if available. Conclusions Asymptomatic, FIT-based CRC screening was feasible and well tolerated in this exploratory analysis. However, the high FIT positivity and low positive predictive value for advanced neoplasia raises concerns about its practicality and cost effectiveness in a low-resource setting such as Nigeria.

scholarly journals Colorectal cancer after negative colonoscopy in fecal immunochemical test-positive participants from a colorectal cancer screening program

2018 ◽  
Vol 06 (09) ◽  
pp. E1140-E1148 ◽  
Author(s):  
Liseth Rivero-Sánchez ◽  
Jaume Grau ◽  
Josep María Augé ◽  
Lorena Moreno ◽  
Angels Pozo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Screening Program ◽  
Fecal Immunochemical Test ◽  
Colorectal Adenomas ◽  
Crc Screening ◽  
Cancer Screening Program ◽  
Screening Strategies ◽  
Immunochemical Test ◽  
Low Incidence

Abstract Background and study aims Colorectal cancer (CRC) risk after a positive fecal immunochemical test (FIT) and negative colonoscopy is unknown. We aimed to ascertain the cumulative incidence of post-colonoscopy colorectal cancer (PCCRC) and the manifestation of other lesions that could explain the test positivity in individuals with a negative colonoscopy in a population screening program. Patients and method Observational study in participants from the first round of a CRC screening program (2010 – 2012) with positive-FIT (≥ 20 μg/g of feces) and negative colonoscopy (without neoplasia). A 42- to 76-month follow-up was performed searching in the National Health Service database and by a brief structured telephonic interview. Results Of 2659 FIT-positive individuals who underwent colonoscopy, 811 (30.5 %) had a negative colonoscopy. Three PCCRC (0.4 %) were detected within 11 – 28 months and accelerated carcinogenesis was ruled out. Among those with normal colonoscopy, 32 (5 %) relevant lesions were detected at follow-up. One-third of them (11/32) were significant neoplasias: a gastric cancer, a small-bowel lymphoma, six advanced colorectal adenomas, and the three PCCRC. The 21 remaining lesions were inflammatory, vascular disorders, or non-advanced colorectal adenomas. Conclusions The vast majority (95 %) of individuals did not present any subsequent lesion that could explain the FIT positivity. The very low incidence (0.4 %) and characteristics of PCCRC observed in our cohort reinforce the concept that, although a positive FIT preselects high risk individuals, a high quality colonoscopy is the paramount factor in preventing PCCRC. Improving quality standards of colonoscopy are required to strengthen the current CRC screening strategies.

Annual colorectal cancer screening in rural community clinics using the fecal immunochemical test (FIT): Second and third year screening.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 35-35
Author(s):  
Connie Arnold ◽  
Terry C Davis ◽  
James Morris ◽  
Glenn Morris Mills
Keyword(s):  
Colorectal Cancer ◽  
Rural Community ◽  
Fecal Immunochemical Test ◽  
Plain Language ◽  
Community Clinics ◽  
Crc Screening ◽  
Number Of Patients ◽  
Limited Literacy ◽  
Immunochemical Test

35 Background: Colorectal cancer (CRC), the second leading cause of cancer death in the US, can be significantly reduced if it is detected early. Although overall CRC screening rates have increased significantly, disparities persist among low income individuals, adults with low literacy and those living in rural areas. Methods: Randomized controlled trial to assess the effectiveness of 2 health literacy informed phone follow-up strategies to improve annual screening with Fecal Immunochemical Test (FIT) in 4 rural community clinics. Eligible patients, age 50-75, were recruited. After consenting, a research assistant (RA) recommended screening and gave literacy and culturally appropriate education using a pamphlet, the FIT kit, simplified instructions and a demonstration of how to use it, At 4 weeks patients who had not returned their kit receive either 1) a personal follow-up call (PC) from a central RA using motivational interviewing skills and reminding them to complete FIT kits; or 2) an automated follow-up call (AC) using plain language and motivational messages encourages patients to complete the FIT. During years 2 and 3, FIT kits were mailed to patients. Follow-up call procedures previously used were followed. Results: 620 patients not up-to-date were enrolled: 308/AC & 306/PC; 66% were African American, 55% women; 40% had limited literacy. During Year 1, 69% completed screening in AC arm versus 67% in PC arm. During Year 2, percentage screened decreased: 40% screened in AC arm and 37% in PC arm. Number of patients that needed at least one follow-up called increased: 74% in both arms needed at least 1 reminder call. Among those called, 19% in the AC arm completed their kit versus 15% in the PC arm. To date in Year 3, 32% screened in AC and 34% in PC. Conclusions: Simplified instructions accompanied by a face-to-face demonstration of FIT, use of “teach back” to confirm understanding with a follow-up call if needed, facilitated completion rates of all patients, particularly those with limited literacy. The less costly and time consuming automated call was equally effective as a personal call. Screening rates in years 2 and 3 declined. CRC screening with FIT is only effective when completed annually. Clinical trial information: RSG-13-021-01 - CPPB.

scholarly journals Low Rates of Colonoscopy Follow-up After a Positive Fecal Immunochemical Test in a Medicaid Health Plan Delivered Mailed Colorectal Cancer Screening Program

2020 ◽  
Vol 11 ◽  
pp. 215013272095852
Author(s):  
Beverly B. Green ◽  
Laura-Mae Baldwin ◽  
Imara I. West ◽  
Malaika Schwartz ◽  
Gloria D. Coronado
Keyword(s):  
Colorectal Cancer ◽  
Health Insurance ◽  
Health Plan ◽  
Fecal Immunochemical Test ◽  
English Speakers ◽  
Outreach Program ◽  
Completion Rates ◽  
Crc Screening ◽  
Immunochemical Test

Background Follow-up colonoscopy after a positive fecal immunochemical test (FIT) is necessary for colorectal cancer (CRC) screening to be effective. We report colonoscopy follow-up rates after a positive FIT overall and by population characteristics in the BeneFIT demonstration pilot, a Medicaid health insurance plan-delivered mailed FIT outreach program. Methods In 2016, 2 health insurance plans in Oregon and in Washington state mailed FIT kits to Medicaid patients who, based on claims data, were overdue for CRC screening. We report follow-up colonoscopy completion rates after positive FIT, and differences in completion rates by age, sex, race, ethnicity, preferred language, and number of primary care visits in the prior year. This research was human subjects approved with a waiver of consent for data collection. Results The FIT positivity rates in Health Plan Oregon and Health Plan Washington were 7.9% (39/488) and 14.6% (125/857), respectively. Colonoscopy completion rates within 12 months of the positive test were 35.9% (14/41) in Health Plan Oregon and 32.8% (41/125) in Health Plan Washington. Colonoscopy completion rates were higher among individuals who preferred a language other than English (Non-English speakers 70.0%, English speakers 31.3%, P = .04). Conclusion In a health plan-delivered mailed FIT outreach program, follow-up colonoscopy rates after a positive test were low. Additional interventions are needed to assure colonoscopy after a positive FIT test and to reap the benefits of screening.

Factors Associated with Participation in Colorectal Cancer Screening Using a Fecal Immunochemical Test (FIT) in Thai Population Aged 45 to 74 years in Namphong District, Khon Kaen Province

2021 ◽  
Vol 104 (7) ◽  
pp. 1067-1072
Keyword(s):  
Public Health ◽  
Colorectal Cancer ◽  
Fecal Immunochemical Test ◽  
Thai Population ◽  
Screening Programs ◽  
Crc Screening ◽  
Factors Associated ◽  
History Of ◽  
Public Health Officials ◽  
Immunochemical Test

Background: Presently, the level of participation in screening programs for colorectal cancer (CRC) with Fecal Immunochemical Test (FIT) is considerably low. Objective: To investigate factors associated with participation in CRC screening using a FIT in the Thai population age 45 to 74 years in the Namphong District of Khon Kaen Province. Materials and Methods: In the present study, the unmatched case-control study design was applied. Three hundred ten participants were equally divided into two groups with 155 participants in the study group and the other 155 in the control group. The data were collected by conducting interviews. Moreover, to explain the association between the factors, multiple logistic regressions were used with adjusted odds ratio (ORadj), a confidence level at 95%, and with p<0.05. Results: It was found that ages were equal to or higher than 60 years (ORadj 2.08; 95%CI 1.19 to 3.63), the lower education level (ORadj 3.70; 95% CI 1.86 to 7.33), a family history of cancer (ORadj 5.25; 95% CI 2.14 to 12.86), receiving advice from public health officials regarding CRC screening (ORadj 3.09; 95% CI 1.81 to 5.27), and high level of knowledge about CRC (ORadj 4.01; 95% CI 2.09 to 7.69) had all been related to participation in the CRC screening program with a statistical significance (p<0.05). Conclusion: The results revealed that receiving advice from public health officials regarding CRC screening and that proper knowledge had been related to participation in screening programs for CRC with the FIT. Thus, to raise awareness and create a greater understanding, public health officers should disseminate knowledge about CRC. Information about the colorectal screening with the FIT should especially be spread to those people who are younger than 60 years of age, have educational levels higher than the primary level, and to those, who have no family history of CRC. Keywords: Colorectal Cancer Screening; Fecal Immunochemical Test (FIT); Thai population

Tu1835 UTILITY OF FECAL IMMUNOCHEMICAL TEST (FIT) FOR COLORECTAL CANCER (CRC) SCREENING IN AFRICAN AMERICAN PATIENTS

2020 ◽  
Vol 158 (6) ◽  
pp. S-1180-S-1181
Author(s):  
Temitayo Gboluaje ◽  
Martha Gwengi ◽  
Titi Olanipekun ◽  
Taiwo A. Ajose ◽  
Krystal Mills ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
African American ◽  
Fecal Immunochemical Test ◽  
Crc Screening ◽  
Immunochemical Test

scholarly journals Cyclomodulins and Hemolysis in E. coli as Potential Low-Cost Non-Invasive Biomarkers for Colorectal Cancer Screening

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1165
Author(s):  
Kristýna Mezerová ◽  
Lubomír Starý ◽  
Pavel Zbořil ◽  
Ivo Klementa ◽  
Martin Stašek ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Low Cost ◽  
E Coli ◽  
Crc Screening ◽  
Non Invasive ◽  
Detection Approach ◽  
Gene Assay ◽  
Immunochemical Test ◽  
The Mean ◽  
And Performance

The frequent occurrence of E. coli positive for cyclomodulins such as colibactin (CLB), the cytotoxic necrotizing factor (CNF), and the cytolethal distending factor (CDT) in colorectal cancer (CRC) patients published so far provides the opportunity to use them as CRC screening markers. We examined the practicability and performance of a low-cost detection approach that relied on culture followed by simplified DNA extraction and PCR in E. coli isolates recovered from 130 CRC patients and 111 controls. Our results showed a statistically significant association between CRC and the presence of colibactin genes clbB and clbN, the cnf gene, and newly, the hemolytic phenotype of E. coli isolates. We also observed a significant increase in the mean number of morphologically distinct E. coli isolates per patient in the CRC cohort compared to controls, indicating that the cyclomodulin-producing E. coli strains may represent potentially preventable harmful newcomers in CRC patients. A colibactin gene assay showed the highest detection rate (45.4%), and males would benefit from the screening more than females. However, because of the high number of false positives, practical use of this marker must be explored. In our opinion, it may serve as an auxiliary marker to increase the specificity and/or sensitivity of the well-established fecal immunochemical test (FIT) in CRC screening.

scholarly journals Quality Improvement of Sample Collection Increases the Diagnostic Accuracy of Quantitative Fecal Immunochemical Test in Colorectal Cancer Screening: A Pilot Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Ru-chen Zhou ◽  
Pei-zhu Wang ◽  
Yue-yue Li ◽  
Yan Zhang ◽  
Ming-jun Ma ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Diagnostic Accuracy ◽  
Fecal Immunochemical Test ◽  
Secondary Outcome ◽  
Diagnostic Efficiency ◽  
Sample Collection ◽  
Crc Screening ◽  
Significant Difference ◽  
Immunochemical Test ◽  
Operant Training

Objective: The diagnostic efficiency of the quantitative fecal immunochemical test (qFIT) has large variations in colorectal cancer (CRC) screening. We aimed to explore whether the practical sample collection operant training could improve the diagnostic accuracy of the qFIT in CRC screening.Methods: Moderate-/high-risk individuals aged 50–75 years old were invited to participate in a prospective observational study between July 2020 and March 2021. Participants took a qFIT sample without fecal sample collection operant training in advance and then completed another qFIT sample after the operant training. The primary outcome was the sensitivity and specificity of the qFITs for CRC and advanced colorectal neoplasia (ACRN). The secondary outcome was the difference in the area under the curves (AUCs) and the concentrations of the fecal hemoglobin (Hb) between the qFIT without and after the operant training.Results: Out of 913 patients, 81 (8.9%) patients had ACRN, including 25 (2.7%) patients with CRC. For CRC, the sensitivities of the qFIT without and after the operant training at 10 μg/g were 80.4 and 100.0%, respectively, and the specificities were 90.1 and 88.4%, respectively. For ACRN, the sensitivities were 49.4 and 69.1% and the specificities were 91.7 and 91.3%, respectively. The AUC of the qFIT after the operant training was significantly higher than that without the operant training for CRC (p = 0.027) and ACRN (p = 0.001). After the operant training, the concentration of the fecal Hb was significantly higher than that without the operant training (p = 0.009) for ACRN, but there was no significant difference for CRC (p = 0.367).Conclusion: Practical sample collection operant training improves the diagnostic accuracy of the qFIT, which increases the detection of the low concentrations of fecal Hb. Improving the quality of the sample collection could contribute to the diagnostic efficiency of the qFIT in CRC screening.

scholarly journals Fecal Immunochemical Test as a Screening Method for Colorectal Cancer in University College Hospital Ibadan, Nigeria

2020 ◽  
pp. 525-531
Author(s):  
Elizabeth O. Labaeka ◽  
Achiaka E. Irabor ◽  
David O. Irabor
Keyword(s):  
Colorectal Cancer ◽  
Screening Method ◽  
Digital Rectal Examination ◽  
Fecal Immunochemical Test ◽  
Positive Finding ◽  
College Hospital ◽  
Crc Screening ◽  
University College ◽  
Immunochemical Test ◽  
Ibadan Nigeria

PURPOSE Colorectal cancer (CRC) is a disease of public health importance because of the increasing incidence of the disease and presentation in advanced stage of the disease in Western Africa. CRC is amenable to screening because of the long course of premalignant lesions before final development of the disease. Despite this, the practice of CRC screening is inadequate at the sites in this study. The fecal immunochemical test (FIT) is one of the recommended noninvasive methods for CRC screening. It has a sensitivity of 96%, specificity of 90%, and an overall accuracy of 95%. We aimed to determine the practicability of FIT for CRC screening in patients aged 40 to 75 years who attended primary care clinics in the University College Hospital, Ibadan, Nigeria. PATIENTS AND METHODS A total of 422 patients selected by systematic random sampling were recruited and offered free FIT screening. Participants with a positive finding had additional GI examination, including a digital rectal examination, proctoscopy, and colonoscopy, if no lesion was biopsied during proctoscopy. RESULTS The mean (± standard deviation) age of the respondents was 62 ± 9.61 years. The prevalence of a positive FIT in the study was 10.1%. The FIT was not completed by 3.8% of patients, and the rate of completion of additional evaluation after a positive FIT reduced as the investigations became invasive, with 36.8% and 71.1% noncompletion rates for proctoscopy and colonoscopy, respectively. CONCLUSION A FIT-based screening for age and risk-appropriate patients is practical in this environment, where the capacity and acceptability of colonoscopy are limited.

An Exploratory Analysis of Fecal Immunochemical Test Performance for Colorectal Cancer Screening in Nigeria

2019 ◽  
Vol 43 (11) ◽  
pp. 2674-2680
Author(s):  
Gregory C. Knapp ◽  
Avinash Sharma ◽  
Bolatito Olopade ◽  
Olusegun I. Alatise ◽  
Olalekan Olasehinde ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Test Performance ◽  
Exploratory Analysis ◽  
Fecal Immunochemical Test ◽  
Immunochemical Test

The results of 3000 Fit: A prospective study led at Saint Joseph University of Beirut.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15141-e15141
Author(s):  
Ronaldo Elkaddoum ◽  
Roland Eid ◽  
Fady Haddad ◽  
Myrna Germanos ◽  
Cybel Mehawej ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Sex Ratio ◽  
Prospective Study ◽  
False Positive ◽  
Medical Genetics ◽  
Fecal Immunochemical Test ◽  
Average Risk ◽  
Intermediate Risk ◽  
Immunochemical Test ◽  
A Prospective Study

e15141 Background: In terms of frequency, colorectal cancer (CRC) is the 3rd cancer in Lebanon with 1093 incidences registered in 2015. To this date not a single screening campaign has been organized in the country. Fecal immunochemical test (FIT) is an advised screening technique. We found it useful to organize a screening campaign using FIT to determine the prevalence of CRC in a population of 3000 healthy Lebanese allowing the extraction of useful data. Methods: 3000 tubes were distributed to Lebanese adults (45-80 years old) at average risk of developing CRC, followed by explanations. FIT analysis was done at the medical genetics unit (UGM) of Saint-Joseph University and patients with positive FIT were asked to undergo further investigations. Results: Out of the 3000 distributed tests, 705 were returned (23.5%) with 459 fully analyzable. The age median was 56 (45-80). Sex ratio F/M 2.3. Out of the 459 patients, 278 (60.5%) showed 0ng/ml, 137 (29.8%) showed 1-79ng/ml, 3 (0.6%) showed 80-99ng/ml (intermediate risk values), 33 (7.1%) showed 100-800ng/ml considered as a positive value and finally 8 (1.7%) showed over range values. Among the 44 positive patients we contacted 41. Out of the 8 (18%) colonoscopies results received: 5 showed hemorrhoids leading to false positive, 1 ulcerative ileitis, 1 tubular adenomas and 1 carcinoma. Conclusions: While it was hard for us to quantify people for whom a free FIT was proposed, the low restitution rate among those who took the test shows the necessity of national screening and sensitization campaigns.

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