scholarly journals Impact of antithrombotics on the fecal immunochemical test for colorectal cancer screening : a multi-center Belgian experience

2021 ◽  
Vol 84 (1) ◽  
pp. 19-24
Author(s):  
L. Wauters ◽  
V.R.H. Van der Voort ◽  
P Dobbels ◽  
K. Hendrickx ◽  
V. Casneuf ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
False Positive ◽  
Older Patients ◽  
Male Gender ◽  
Fecal Immunochemical Test ◽  
High Grade ◽  
Crc Screening ◽  
Gi Symptoms ◽  
Immunochemical Test ◽  
Villous Adenomas

Background : Impact of antithrombotics on the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening remains unclear. Methods : Patients undergoing colonoscopy for positive FIT in 2015 were assessed at 3 Belgian centers. Significant findings were advanced polyps (AP) (sessile serrated, tubular or villous adenomas >1cm or high-grade dysplasia) and CRC. False positive FIT and detection of AP/CRC with antithrombotics were calculated. Results : 510 patients (64% male, median (IQR) age 63.2 (60.2-66.4) years) were included. Colorectal pathology in 371/510 (73%) was associated with male gender (70% vs. 48% ; p= .0001) and family history (16% vs. 8% ; p= .02). Antithrombotics in 125/510 (25%) were associated with male gender (78% vs. 59% ; p= .0001), older age (65.2 (62.2-70.3) vs. 62.3 (58.7-66.3) years ; p= .0001) and GI-symptoms (18% vs. 11% ; p= .04). False positive FIT (25% vs. 28% ; p= .52) and detection of AP (42% vs. 36% ; p= .27) or CRC (6% vs. 5% ; p= .69) were similar in patients with vs. no antithrombotics. Use of antithrombotics did not predict a higher chance of colorectal pathology after adjusting for confounders. Conclusion : Although antithrombotics were prescribed more frequently in male and older patients, detection of AP/CRC was similar. Despite increased GI symptoms, false positive FIT was similar with antithrombotics.

scholarly journals New fecal bacterial signature for colorectal cancer screening reduces the fecal immunochemical test false-positive rate in a screening population

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243158
Author(s):  
Marta Malagón ◽  
Sara Ramió-Pujol ◽  
Marta Serrano ◽  
Joan Amoedo ◽  
Lia Oliver ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
False Positive ◽  
False Positive Rate ◽  
Fecal Immunochemical Test ◽  
Noninvasive Test ◽  
Screening Programs ◽  
Crc Screening ◽  
Positive Rate ◽  
Immunochemical Test ◽  
Advanced Adenomas

Guidelines recommend routine screening for colorectal cancer (CRC) in asymptomatic adults starting at age 50. The most extensively used noninvasive test for CRC screening is the fecal immunochemical test (FIT), which has an overall sensitivity for CRC of approximately 61.0%-91.0%, which drops to 27.0%-67.0% for advanced adenomas. These figures contain a high false-positive rate and a low positive predictive value. This work aimed to develop a new, noninvasive CRC screening tool based on fecal bacterial markers capable of decreasing FIT false-positive rates in a FIT-positive population. We defined a fecal bacterial signature (RAID-CRC Screen) in a proof-of-concept with 172 FIT-positive individuals and validated the obtained results on an external cohort of 327 FIT-positive subjects. All study participants had joined the national CRC screening program. In the clinical validation of RAID-CRC Screen, a sensitivity of 83.9% and a specificity of 16.3% were obtained for the detection of advanced neoplasm lesions (advanced adenomas and/or CRC). FIT 20 μg/g produced 184 false-positive results. Using RAID-CRC Screen, this value was reduced to 154, thus reducing the false-positive rate by 16.3%. The RAID-CRC Screen test could be implemented in CRC screening programs to allow a significant reduction in the number of colonoscopies performed unnecessarily for FIT-positive participants of CRC screening programs.

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 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.

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.

scholarly journals A large proportion of fecal immunochemical test-positive participants in colorectal cancer screening is symptomatic

2017 ◽  
Vol 6 (3) ◽  
pp. 471-479 ◽  
Author(s):  
Clasine M de Klerk ◽  
Manon van der Vlugt ◽  
Patrick M Bossuyt ◽  
Evelien Dekker
Keyword(s):  
Colorectal Cancer ◽  
General Practitioner ◽  
Cancer Screening ◽  
Odds Ratio ◽  
Screening Program ◽  
Daily Practice ◽  
Fecal Immunochemical Test ◽  
Crc Screening ◽  
Advanced Neoplasia ◽  
Immunochemical Test

Background Symptomatic invitees are advised not to participate in colorectal cancer (CRC) screening but to directly consult their general practitioner (GP), because fecal immunochemical test (FIT) sensitivity for cancer is not optimal. This recommendation may not always be followed in daily practice. We evaluated how many FIT-positive participants had CRC-related symptoms and whether the presence of symptoms was associated with the presence and location of CRC/advanced neoplasia. Methods We prospectively collected data on CRC-related symptoms in all FIT-positive participants in the Dutch CRC screening program, referred to our endoscopy centers between 2014 and 2016, and evaluated whether symptoms were associated with detected CRC/advanced neoplasia at colonoscopy. Results Of 527 FIT-positive participants, 314 had advanced neoplasia, of which 41 had CRC. Overall, 246 (47%; 95% confidence interval (CI) 0.42–0.51) reported CRC-related symptoms. A change in bowel habits (odds ratio (OR) 2.86, CI 1.23–6.62) and visible blood in stool (OR 8.65, CI 2.34–32.0) were associated with the detection of CRC at colonoscopy. We did not observe significant associations between evaluated symptoms and advanced neoplasia. Conclusions A large proportion of FIT-positive screening participants have CRC-related symptoms. This suggests that current instructions do not retain symptomatic screening invitees from participation and awareness of CRC-related symptoms is inadequate.

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.

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