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Digby, Jayne; Fraser, Callum G; Carey, Francis A; Lang, Jaroslaw; Stanners, Greig; Steele, Robert JC

Interval cancers using a quantitative faecal immunochemical test (FIT) for haemoglobin when colonoscopy capacity is limited

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  • Medientyp: E-Artikel
  • Titel: Interval cancers using a quantitative faecal immunochemical test (FIT) for haemoglobin when colonoscopy capacity is limited
  • Beteiligte: Digby, Jayne; Fraser, Callum G; Carey, Francis A; Lang, Jaroslaw; Stanners, Greig; Steele, Robert JC
  • Erschienen: SAGE Publications, 2016
  • Erschienen in: Journal of Medical Screening, 23 (2016) 3, Seite 130-134
  • Sprache: Englisch
  • DOI: 10.1177/0969141315609634
  • ISSN: 0969-1413; 1475-5793
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: Objectives Quantitative faecal immunochemical tests (FIT) for faecal haemoglobin (f-Hb) in colorectal cancer (CRC) screening pose challenges when colonoscopy is limited. For low positivity rates, high f-Hb concentration cut-offs are required, but little is known about interval cancer (IC) proportions using FIT. We assessed IC proportions using an 80 µg Hb/g cut-off. Methods In two NHS Boards in the Scottish Bowel Screening Programme, f-Hb was estimated for 30,893 participants aged 50–75, of whom 753 participants with f-Hb ≥ 80 µg Hb/g were referred for colonoscopy. ICs, defined as CRC within two years of a negative result, were identified from the Scottish Cancer Registry. Results There were 31 ICs and 30 screen-detected (SD) CRCs, an IC proportion of 50.8% (48.4% for men, 53.3% for women). CRC site distribution was similar between ICs and SD, but ICs were later stage (46.7% and 33.3%, Dukes’ stages C and D, respectively). Of 31 ICs, 23 had f-Hb < 10 µg Hb/g, including six with undetectable f-Hb. A f-Hb cut-off of 10 µg Hb/g would have raised the positivity rate from 2.4% to 9.4%, increased colonoscopy requirement from 753 to 2147, and reduced the IC proportion to 38.3%. Conclusions The IC proportion was similar to that seen with guaiac-based FOBT. The later stage distribution of ICs highlights the benefits of lower f-Hb cut-offs, but with 19.4% of ICs having undetectable f-Hb, some cancers would have been missed, even with drastic reduction in the f-Hb cut-off.
  • Zugangsstatus: Freier Zugang