Clinical outcomes using a faecal immunochemical test for haemoglobin as a first-line test in a national programme constrained by colonoscopy capacity

被引:61
作者
Steele, Robert J. C. [1 ]
McDonald, Paula J. [2 ]
Digby, Jayne [2 ]
Brownlee, Linda [2 ]
Strachan, Judith A. [2 ]
Libby, Gillian [2 ]
McClements, Paula L. [3 ]
Birrell, Janice [4 ]
Carey, Francis A. [5 ]
Diament, Robert H. [6 ]
Balsitis, Margaret [7 ]
Fraser, Callum G. [8 ]
机构
[1] Univ Dundee, Ninewells Hosp & Med Sch, Dept Surg, Dundee DD1 9SY, Scotland
[2] NHS Tayside, Scottish Bowel Screening Ctr, Dundee, Scotland
[3] NHS Natl Serv Scotland, Informat Serv Div, Edinburgh, Midlothian, Scotland
[4] NHS Natl Serv Scotland, Natl Serv Div, Edinburgh, Midlothian, Scotland
[5] Univ Dundee, Ninewells Hosp & Med Sch, Dept Pathol, Dundee DD1 9SY, Scotland
[6] Crosshouse Hosp, Dept Surg, Kilmarnock, Scotland
[7] Crosshouse Hosp, Dept Pathol, Kilmarnock, Scotland
[8] Univ Dundee, Ninewells Hosp & Med Sch, Ctr Res Canc Prevent Screening, Dundee DD1 9SY, Scotland
关键词
Colorectal cancer; faecal immunochemical test; faecal occult blood test; positive predictive value; screening;
D O I
10.1177/2050640613489281
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Introduction: Because of their many advantages, faecal immunochemical tests (FIT) are superseding traditional guaiac-based faecal occult blood tests in bowel screening programmes. Methods: A quantitative FIT was adopted for use in two evaluation National Health Service (NHS) Boards in Scotland using a cut-off faecal haemoglobin concentration chosen to give a positivity rate equivalent to that achieved in the Scottish Bowel Screening Programme. Uptake and clinical outcomes were compared with results obtained contemporaneously in two other similar NHS Boards and before and after the evaluation in the two evaluation NHS Boards. Results: During the evaluation, uptake was 58.5%. This was higher than in the same NHS Boards both before and after the evaluation, higher than in the other two NHS Boards and higher than the 53.7% achieved overall in Scotland. The overall positivity rate was higher in men than in women and increased with age in both genders. Positive predictive values for cancer (4.8%), high-risk adenoma (23.3%), all adenoma (38.2%) and all neoplasia (43.0%) in the two test NHS Boards were similar in all groups. Conclusions: In summary, this evaluation of the FIT supports the introduction of FIT as a first-line test, even when colonoscopy capacity is limited.
引用
收藏
页码:198 / 205
页数:8
相关论文
共 25 条
[1]   Screening for colorectal neoplasms with new fecal occult blood tests: update on performance characteristics [J].
Allison, James E. ;
Sakoda, Lori C. ;
Levin, Theodore R. ;
Tucker, Jo P. ;
Tekawa, Irene S. ;
Cuff, Thomas ;
Pauly, Mary Pat ;
Shlager, Lyle ;
Palitz, Albert M. ;
Zhao, Wei K. ;
Schwartz, J. Sanford ;
Ransohoff, David F. ;
Selby, Joseph V. .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2007, 99 (19) :1462-1470
[2]   Surveillance guidelines after removal of colorectal adenomatous polyps [J].
Atkin, WS ;
Saunders, BP .
GUT, 2002, 51 :V6-V9
[3]   Towards complete and accurate reporting of studies of diagnostic accuracy: The STARD initiative [J].
Bossuyt, PM ;
Reitsma, JB ;
Bruns, DE ;
Gatsonis, CA ;
Glasziou, PP ;
Irwig, LM ;
Lijmer, JG ;
Moher, D ;
Rennie, D ;
de Vet, HCW .
CLINICAL CHEMISTRY, 2003, 49 (01) :1-6
[4]   Experience with a two-tier reflex gFOBT/FIT strategy in a national bowel screening programme [J].
Fraser, Callum G. ;
Digby, Jayne ;
McDonald, Paula J. ;
Strachan, Judith A. ;
Carey, Francis A. ;
Steele, Robert J. C. .
JOURNAL OF MEDICAL SCREENING, 2012, 19 (01) :8-13
[5]  
Fraser CG, 2011, CLIN LAB NEWS, V37, P8
[6]   Immunochemical faecal occult blood test: number of samples and positivity cutoff. What is the best strategy for colorectal cancer screening? [J].
Grazzini, G. ;
Visioli, C. B. ;
Zorzi, M. ;
Ciatto, S. ;
Banovich, F. ;
Bonanomi, A. G. ;
Bortoli, A. ;
Castiglione, G. ;
Cazzola, L. ;
Confortini, M. ;
Mantellini, P. ;
Rubeca, T. ;
Zappa, M. .
BRITISH JOURNAL OF CANCER, 2009, 100 (02) :259-265
[7]   Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (Hemoccult): An update [J].
Hewitson, Paul ;
Glasziou, Paul ;
Watson, Eila ;
Towler, Bernie ;
Irwig, Les .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2008, 103 (06) :1541-1549
[8]   Screening for colorectal cancer: randomised trial comparing guaiac-based and immunochemical faecal occult blood testing and flexible sigmoidoscopy [J].
Hol, L. ;
van Leerdam, M. E. ;
van Ballegooijen, M. ;
van Vuuren, A. J. ;
van Dekken, H. ;
Reijerink, J. C. I. Y. ;
van der Togt, A. C. M. ;
Habbema, J. D. F. ;
Kuipers, E. J. .
GUT, 2010, 59 (01) :62-68
[9]   Screening for colorectal cancer: random comparison of guaiac and immunochemical faecal occult blood testing at different cut-off levels [J].
Hol, L. ;
Wilschut, J. A. ;
van Ballegooijen, M. ;
van Vuuren, A. J. ;
van der Valk, H. ;
Reijerink, J. C. I. Y. ;
van der Togt, Acm ;
Kuipers, E. J. ;
Habbema, J. D. F. ;
van Leerdam, Me .
BRITISH JOURNAL OF CANCER, 2009, 100 (07) :1103-1110
[10]  
Information Services Division (ISD) National Services Scotland, 2011, BOW SCREEN PROGR ANN