scholarly journals Faecal haemoglobin concentrations in women and men diagnosed with colorectal cancer in a national screening programme

2021 ◽  
pp. 096914132110569
Author(s):  
Gavin RC Clark ◽  
Jayne Digby ◽  
Callum G Fraser ◽  
Judith A Strachan ◽  
Robert JC Steele
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Haemoglobin Concentration ◽  
Gender Inequalities ◽  
Anatomical Site ◽  
Faecal Immunochemical Test ◽  
Immunochemical Test ◽  
The Difference

Objective There is evidence that colorectal cancer screening using faecal haemoglobin is less effective in women than men. The faecal haemoglobin concentrations were therefore examined in women and men with screen-detected colorectal cancer. Setting Scottish Bowel Screening Programme, following the introduction of a faecal immunochemical test from November 2017, to March 2020. Methods Data were collated on faecal haemoglobin concentrations, pathological stage and anatomical site of the main lesion in participants who had colorectal cancer detected. The data in women and men were compared. Results For the faecal haemoglobin concentrations studied (>80 µg Hb/g faeces), the distributions indicated lower concentrations in women. Marked differences were found between women and men diagnosed with colorectal cancer. The median faecal haemoglobin concentration for women ( n = 720) was 408 µg Hb/g faeces compared to 473 µg Hb/g faeces for men ( n = 959) ( p = 0.004) and 50.6% of the results were >400 µg Hb/g faeces in women; in men, this was 57.8%. The difference in faecal haemoglobin concentrations in women and men became less statistically significant as stage advanced from stages I–IV. For right-sided, left-sided and rectal colorectal cancer, a similar gender difference persisted in all sites. Differences in faecal haemoglobin between the genders were significant for left-sided cancers and stage I and approached significance for rectal cancers and stage II, but all sites and stages showed lower median faecal haemoglobin concentrations for women. Conclusions To minimise gender inequalities, faecal immunochemical test-based colorectal cancer screening programmes should evaluate a strategy of using different faecal haemoglobin concentration thresholds in women and men.

scholarly journals Interval cancers after negative immunochemical test compared to screen and non-responders’ detected cancers in Slovenian colorectal cancer screening programme

2018 ◽  
Vol 52 (4) ◽  
pp. 413-421 ◽  
Author(s):  
Dominika Novak Mlakar ◽  
Tatjana Kofol Bric ◽  
Ana Lucija Škrjanec ◽  
Mateja Krajc
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Test ◽  
Screening Programme ◽  
Interval Cancers ◽  
Faecal Immunochemical Test ◽  
Test Sensitivity ◽  
Cancer Screening Programme ◽  
Immunochemical Test

Abstract Background We assessed the incidence and characteristics of interval cancers after faecal immunochemical occult blood test and calculated the test sensitivity in Slovenian colorectal cancer screening programme. Patients and methods The analysis included the population aged between 50 to 69 years, which was invited for screening between April 2011 and December 2012. The persons were followed-up until the next foreseen invitation, in average for 2 years. The data on interval cancers and cancers in non-responders were obtained from cancer registry. Gender, age, years of schooling, the cancer site and stage were compared among three observed groups. We used the proportional incidence method to calculate the screening test sensitivity. Results Among 502,488 persons invited for screening, 493 cancers were detected after positive screening test, 79 interval cancers after negative faecal immunochemical test and 395 in non-responders. The proportion of interval cancers was 13.8%. Among the three observed groups cancers were more frequent in men (p = 0.009) and in persons aged 60+ years (p < 0.001). Comparing screen detected and cancers in non-responders with interval cancers more interval cancers were detected in persons with 10 years of schooling or more (p = 0.029 and p = 0.001), in stage III (p = 0.027) and IV (p < 0.001), and in right hemicolon (p < 0.001). Interval cancers were more frequently in stage I than non-responders cancers (p = 0.004). Test sensitivity of faecal immunochemical test was 88.45%. Conclusions Interval cancers in Slovenian screening programme were detected in expected proportions as in similar programmes. Test sensitivity was among the highest when compared to similar programmes and was accomplished using test kit for two stool samples.

Colonoscopy may be weak link in organised colorectal cancer screening programme with faecal immunochemical test

2021 ◽  
pp. 096914132110611
Author(s):  
Bernard Denis ◽  
Isabelle Gendre
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Lesion Detection ◽  
Faecal Immunochemical Test ◽  
Adenoma Detection ◽  
Cancer Screening Programme ◽  
Immunochemical Test ◽  
Serrated Lesion

Objective To evaluate the quality of colonoscopies performed after a positive faecal immunochemical test in the French colorectal cancer screening programme. Methods Retrospective analysis of all colonoscopies performed between 2015 and 2019 after a positive quantitative faecal immunochemical test in the population-based colorectal cancer screening programme organised in Alsace, part of the French programme. The following indicators were evaluated: annual colonoscopy volume, caecal intubation rate, adenoma detection rate, proximal serrated lesion detection rate and proportion of patients referred directly to surgery for benign polyp management. Endoscopists who performed <30 faecal immunochemical test positive colonoscopies were non-assessable. Results Overall, 13,455 faecal immunochemical test-positive colonoscopies performed by 116 community gastroenterologists were included, 13,067 of them by 80 assessable endoscopists. The overall caecal intubation, adenoma detection and proximal serrated lesion detection rates were 97.9%, 57.6% and 7.6%, respectively. They were <90%, <45% and <1% for 1.3%, 12.5% and 6.3% of the endoscopists, respectively. Overall, 1028 (7.9%) individuals were examined by 13 low-performing endoscopists and 328 (2.4%) individuals by 33 low-volume non-assessable endoscopists. Among 9133 individuals harbouring polyps, 155 (1.7%) had unwarranted surgery for a benign polyp. Overall, 1487 individuals (11.1%; 95% confidence interval 10.5–11.6) were not given the best possible chances, whereas 5545 individuals (41.2%; 95% confidence interval 40.4–42.0) were offered the best possible chances by 37 endoscopists. Conclusions At programme level, the key performance indicators evaluated largely exceeded the target standards. At individual level, at least one in nine individuals was not given the best possible chances during faecal immunochemical test-positive colonoscopies by a minority of poor-performing and/or low-volume endoscopists.

Faecal immunochemical test-based colorectal cancer screening programme SVIT in Slovenia

2014 ◽  
Vol 23 (4) ◽  
pp. 235-239 ◽  
Author(s):  
Bojan Tepeš ◽  
Borut Štabuc ◽  
Milan Stefanovič ◽  
Matej Bračko ◽  
Snežana Frkovič Grazio ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Faecal Immunochemical Test ◽  
Cancer Screening Programme ◽  
Immunochemical Test

scholarly journals Factors related to the participation and detection of lesions in colorectal cancer screening programme-based faecal immunochemical test

2018 ◽  
Vol 28 (6) ◽  
pp. 1143-1148 ◽  
Author(s):  
Isabel Portillo ◽  
Eunate Arana-Arri ◽  
Iñaki Gutiérrez-Ibarluzea ◽  
Isabel Bilbao ◽  
Jose Luis Hurtado ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Faecal Immunochemical Test ◽  
Cancer Screening Programme ◽  
Immunochemical Test

Stable prevalence of faecal immunochemical test positivity over time in Italy

2019 ◽  
Vol 27 (3) ◽  
pp. 168-169
Author(s):  
Manuel Zorzi ◽  
Jessica Battagello ◽  
Massimo Rugge
Keyword(s):  
Colorectal Cancer ◽  
Cancer Screening ◽  
Colorectal Cancer Screening ◽  
Screening Programme ◽  
Latex Agglutination ◽  
Faecal Immunochemical Test ◽  
North East ◽  
Cancer Screening Programme ◽  
Immunochemical Test ◽  
Over Time

Objectives The prevalence of guaiac faecal occult blood positivity among participants aged 50 in the Scottish Bowel Screening Programme showed a significant increase from 2007 to 2017. As a comparison, we examined the trend in the prevalence of faecal immunochemical test (FIT) positivity among participants aged 50 in the colorectal cancer screening programme of the Veneto region (north-east Italy) from 2006 to 2018. Methods The target population includes residents aged 50–69, who are invited to repeat the FIT every two years. The screening programme uses the OC-Hemodia latex agglutination test, with a cut-off for positivity of 20 µg of haemoglobin per g of faeces. Results Based on 182,275 FITs performed on participants aged 50, overall FIT positivity was 3.6% in 2006 (95% confidence interval (CI): 3.1–4.2) and 3.7% (95% CI: 3.4–3.9) in 2018, showing no significant trend ( p = 0.19). The prevalence of positive test results was higher in males throughout the study period. No gradient was seen for men (2006 = 4.4%, 95% CI: 3.6–5.3; 2018 = 4.2%, 95% CI: 3.9–4.6; p = 0.10) or women (2006 = 2.8%, 95% CI: 2.1–3.5; 2018 = 3.2%, 95% CI: 2.9–3.5; p = 0.84). Conclusions In a FIT-based colorectal cancer screening programme in Italy, the test positivity over time was stable. Our findings suggest that the interpretation of faecal haemoglobin levels may not be geographically transferable.

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