Usefulness of the fecal immunochemical test in the detection of advanced adenomas in subjects at average risk for colorectal cancer

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

PLoS ONE ◽

10.1371/journal.pone.0243158 ◽

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.

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Tu1183 Fecal Immunochemical Test Accuracy for Colorectal Cancer and Significant Neoplasia Detection in Average-Risk Population

Gastroenterology ◽

10.1016/s0016-5085(12)62977-1 ◽

2012 ◽

Vol 142 (5) ◽

pp. S-768 ◽

Cited By ~ 2

Author(s):

Vicent Hernandez ◽

Joaquin Cubiella ◽

Carmen Gonzalez-Mao ◽

Begoña Iglesias Rodriguez ◽

Lucia Cid ◽

...

Keyword(s):

Colorectal Cancer ◽

Fecal Immunochemical Test ◽

Test Accuracy ◽

Average Risk ◽

Risk Population ◽

Immunochemical Test

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Correlating Quantitative Fecal Immunochemical Test Results with Neoplastic Findings on Colonoscopy in a Population-Based Colorectal Cancer Screening Program: A Prospective Study

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2016/4650471 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Neal Shahidi ◽

Laura Gentile ◽

Lovedeep Gondara ◽

Jeremy Hamm ◽

Colleen E. McGahan ◽

...

Keyword(s):

Colorectal Cancer ◽

Screening Program ◽

Population Based ◽

Fecal Immunochemical Test ◽

Average Risk ◽

Health Authorities ◽

Cancer Screening Program ◽

Immunochemical Test ◽

A Prospective Study ◽

The Cost

Background and Aims. The Canadian Partnership Against Cancer (CPAC) recommends a fecal immunochemical test- (FIT-) positive predictive value (PPV) for all adenomas of ≥50%. We sought to assess FIT performance among average-risk participants of the British Columbia Colon Screening Program (BCCSP).Methods.From Nov-2013 to Dec-2014 consecutive participants of the BCCSP were assessed. Data was obtained from a prospectively collected database. A single quantitative FIT (NS-Plus, Alfresa Pharma Corporation, Japan) with a cut-off of ≥10 μg/g (≥50 ng/mL) was used.Results. 20,322 FIT-positive participants underwent CSPY. At a FIT cut-off of ≥10 μg/g (≥50 ng/mL) the PPV for all adenomas was 52.0%. Increasing the FIT cut-off to ≥20 μg/g (≥100 ng/mL) would increase the PPV for colorectal cancer (CRC) by 1.5% and for high-risk adenomas (HRAs) by 6.5% at a cost of missing 13.6% of CRCs and 32.4% of HRAs.Conclusions.As the NS-Plus FIT cut-off rises, the PPV for CRC and HRAs increases but at the cost of missed lesions. A cut-off of ≥10 μg/g (≥50 ng/mL) produces a PPV for all adenomas exceeding national recommendations. Health authorities need to take into consideration endoscopic resources when selecting a FIT positivity threshold.

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Fecal immunochemical test accuracy in average-risk colorectal cancer screening

World Journal of Gastroenterology ◽

10.3748/wjg.v20.i4.1038 ◽

2014 ◽

Vol 20 (4) ◽

pp. 1038 ◽

Cited By ~ 32

Author(s):

Vicent Hernandez

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Fecal Immunochemical Test ◽

Test Accuracy ◽

Average Risk ◽

Immunochemical Test

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

PLoS ONE ◽

10.1371/journal.pone.0243587 ◽

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.

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