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

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
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.

scholarly journals Management of large polyps in a colorectal cancer screening program with fecal immunochemical test: a community- and population-based observational study

2021 ◽  
Vol 09 (11) ◽  
pp. E1649-E1657
Author(s):  
Bernard Denis ◽  
Isabelle Gendre ◽  
Philippe Perrin ◽  
Nicolas Tuzin ◽  
Mathieu Pioche
Keyword(s):  
Colorectal Cancer ◽  
Observational Study ◽  
Endoscopic Resection ◽  
Screening Program ◽  
Population Based ◽  
Fecal Immunochemical Test ◽  
Detection Rates ◽  
Cancer Screening Program ◽  
Adenoma Detection ◽  
Immunochemical Test

Abstract Background and study aims The aim of this study was to analyze presentation, management, and outcomes of large polyps (LPs; ≥ 20 mm) detected in a colorectal cancer (CRC) screening program using a quantitative fecal immunochemical test (FIT). Patients and methods This was a retrospective community- and population-based observational study of all LPs detected in patients aged 50 to 74 years between 2015 and 2019 during FIT-positive colonoscopies within the screening program organized in Alsace (France). Results Among 13,633 FIT-positive colonoscopies, 1256 LPs (8.5 % malignant and 51.8 % nonpedunculated) were detected by 102 community gastroenterologists in 1164 patients (one in 12 colonoscopies). The sensitivity of optical diagnosis of malignancy was 54 % for nonpedunculated and 27 % for pedunculated T1 CRCs. The endoscopic resection rate was 82.7 % (95 % confidence interval [CI] 80.3–84.9) for benign LPs (70.2 % [95 % CI 66.4–74.1]) nonpedunculated, 95.2 % [95 % CI 93.4–97.1] pedunculated), varying from 0 to 100 % depending on the endoscopist. It was correlated with cecal intubation (Pearson r = 0.49, P < 0.01) and adenoma detection rates (r = 0.25, P = 0.01). Most endoscopists did not refer patients to more experienced endoscopists, and as a result, 60 % to 90 % of 183 surgeries for benign LPs were unwarranted. Endoscopic resection was curative for 4.3 % (95 % CI 0.9–12.0) of nonpedunculated and 37.8 % (95 % CI 22.5–55.2) of pedunculated T1 CRCs. Overall, 22 endoscopic submucosal dissections had to be performed to avoid one surgery. Conclusions Compared with current recommendations, there is tremendous room for improvement in community endoscopy practices in the diagnosis and management of LPs. Detection and polypectomy competencies are correlated and highly variable among endoscopists. Endoscopic resection is curative for 83 % of benign LPs and 16 % of T1 CRCs.

scholarly journals Management of large polyps in a colorectal cancer screening program with fecal immunochemical test: a population-based study

2020 ◽  
Author(s):  
Bernard Denis ◽  
Isabelle Gendre ◽  
Philippe Perrin ◽  
Nicolas Tuzin ◽  
Mathieu Pioche
Keyword(s):  
Colorectal Cancer ◽  
Endoscopic Resection ◽  
Screening Program ◽  
Population Based ◽  
Fecal Immunochemical Test ◽  
Cecal Intubation ◽  
Population Based Study ◽  
Cancer Screening Program ◽  
Adenoma Detection ◽  
Immunochemical Test

Objective: To analyze presentation, management and outcomes of large (≥ 20 mm) polyps (LPs) detected in a colorectal cancer (CRC) screening program using a fecal immunochemical test (FIT). Design: Retrospective population-based study of all LPs detected in patients aged 50-74 years between 2015 and 2019 during FIT-positive colonoscopies within the screening program organized in Alsace (France). Results: Among 13,633 FIT-positive colonoscopies, 1256 LPs (8.5% malignant and 51.8% non-pedunculated) were detected by 102 community gastroenterologists in 1164 patients (one in 12 colonoscopies). The sensitivity of optical diagnosis of malignancy was 54% for non-pedunculated and 27% for pedunculated T1 CRCs. Endoscopic resection rate was 82.7% [95% CI 80.3-84.9] for benign LPs (70.2% [95% CI 66.4-74.1] non-pedunculated, 95.2% [95% CI 93.4-97.1] pedunculated, p<0.001), varying from 0 to 100% depending on the endoscopist. It was correlated with cecal intubation (Pearson r = 0.49, p<0.01) and adenoma detection (r = 0.25, p=0.01) rates. Most endoscopists did not refer patients to more experienced endoscopists, so that 60 to 90% of 183 surgeries for benign LPs were unwarranted. Endoscopic resection was curative for 4.3% [95% CI 0.9-12.0] of non-pedunculated and 37.8% [95% CI 22.5-55.2] of pedunculated T1 CRCs. Overall, 22 endoscopic submucosal dissections had to be performed to avoid one surgery. Conclusion: Compared with current recommendations, there is tremendous room for improvement of community endoscopy practices for the diagnosis and management of LPs. Detection and polypectomy competencies are correlated and highly variable among endoscopists. Endoscopic resection is curative in 83% of benign LPs and 16% of T1 CRCs.

scholarly journals Quality Metrics of a Fecal Immunochemical Test-Based Colorectal Cancer Screening Program in Korea

Gut and Liver ◽  
2018 ◽  
Vol 12 (2) ◽  
pp. 183-189 ◽  
Author(s):  
Dae Ho Kim ◽  
Jae Myung Cha ◽  
Min Seob Kwak ◽  
Jin Young Yoon ◽  
Young-Hak Cho ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Program ◽  
Quality Metrics ◽  
Fecal Immunochemical Test ◽  
Cancer Screening Program ◽  
Immunochemical Test

scholarly journals Early Screening of African Americans (45–50 Years Old) in a Fecal Immunochemical Test–Based Colorectal Cancer Screening Program

2020 ◽  
Vol 159 (5) ◽  
pp. 1695-1704.e1
Author(s):  
Theodore R. Levin ◽  
Christopher D. Jensen ◽  
Neetu M. Chawla ◽  
Lori C. Sakoda ◽  
Jeffrey K. Lee ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
African Americans ◽  
Colorectal Cancer Screening ◽  
Screening Program ◽  
Fecal Immunochemical Test ◽  
Early Screening ◽  
Cancer Screening Program ◽  
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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