Is It Necessary to Repeat Fecal Occult Blood Tests with Borderline Results for Colorectal Cancer Screening?
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
The fecal immunochemical test (FIT) is the initial non-invasive investigation of choice for population-based colorectal cancer (CRC) screening. We evaluated the positivity rate in repeated tests using the same fecal specimen that showed borderline results in the FIT. A total of 6,465 patients were tested with the FIT in a tertiary-care hospital from July to December 2016. FIT was done using OC-Sensor PLEDIA (Eiken Chemical Co., Tokyo, Japan). Among 6,465 patients, 364 (5.6%) patients showed a positive FIT result of over 20 μg Hb/g feces. A total of 112 (1.7%) patients showed borderline scores of 10.2–20 μg Hb/g feces, and 5,989 (92.6%) patients showed negative results of less than 10 μg Hb/g feces. Among the 101 repeat-tested patients, 19 (18.8%) of the patients’ scores converted to levels above the positive cut-off threshold. Repeated results of 19 patients showed score elevations from 20.2 to 68 μg Hb/g feces. These results suggest that it is most important to analyze properly prepared samples, even if only once. Therefore, the laboratory staff should ensure the proper preparation of stool specimens for FIT. Laboratory directors should choose the best cut-off value for detecting CRC at their respective institutions.
Abstract
The fecal immunochemical test (FIT) is the initial non-invasive investigation of choice for population-based colorectal cancer (CRC) screening. We evaluated the positivity rate in repeated tests using the same fecal specimen that showed borderline results in the FIT. A total of 6,465 patients were tested with the FIT in a tertiary-care hospital from July to December 2016. FIT was done using OC-Sensor PLEDIA (Eiken Chemical Co., Tokyo, Japan). Among 6,465 patients, 364 (5.6%) patients showed a positive FIT result of over 20 μg Hb/g feces. A total of 112 (1.7%) patients showed borderline scores of 10.2–20 μg Hb/g feces, and 5,989 (92.6%) patients showed negative results of less than 10 μg Hb/g feces. Among the 101 repeat-tested patients, 19 (18.8%) of the patients’ scores converted to levels above the positive cut-off threshold. Repeated results of 19 patients showed score elevations from 20.2 to 68 μg Hb/g feces. These results suggest that it is most important to analyze properly prepared samples, even if only once. Therefore, the laboratory staff should ensure the proper preparation of stool specimens for FIT. Laboratory directors should choose the best cut-off value for detecting CRC at their respective institutions.
참고문헌 (14)
- Lieberman D, "Screening for colorectal cancer and evolving issues for physicians and patients: a Review", JAMA, 316, pp.2135~2145 (2016)[DOI]
- Force USPST, "Screening for colorectal cancer: US preventive services task force recommendation statement", JAMA, 315, pp.2564~2575 (2016)[DOI]
- Chiang TH, "Difference in performance of fecal immunochemical tests with the same hemoglobin cutoff concentration in a nationwide colorectal cancer screening program", Gastroenterology, 147, pp.1317~1326 (2014)[DOI]
- Quintero E, "Colonoscopy versus fecal immunochemical testing in colorectal-cancer screening", N Engl J Med, 366, pp.697~706 (2012)[DOI]
- Fraser CG, "Improving the reporting of evaluations of faecal immunochemical tests for haemoglobin: the FITTER standard and checklist", Eur J Cancer Prev, 24, pp.24~26 (2015)
- Passamonti B, "A comparative effectiveness trial of two faecal immunochemical tests for haemoglobin (FIT). Assessment of test performance and adherence in a single round of a population-based screening programme for colorectal cancer", Gut (2016)[DOI]
- Fraser CG, "A proposal to standardize reporting units for fecal immunochemical tests for hemoglobin", J Natl Cancer Inst, 104, pp.810~814 (2012)[DOI]
- Kapidzic A, "Attendance and diagnostic yield of repeated two-sample faecal immunochemical test screening for colorectal cancer", Gut, 66, pp.118~123 (2017)[DOI]
- van Turenhout ST, "Similar fecal immunochemical test results in screening and referral colorectal cancer", World J Gastroenterol, 18, pp.5397~5403 (2012)[DOI]
- Akram A, "Fecal immunochemical testing: a sensitive and sustainable approach for population colorectal cancer screening?", Gastroenterology, 151, pp.554~555 (2016)[DOI]
- Whitlock EP, "Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force", Ann Intern Med, 149, pp.638~658 (2008)[DOI]
- van Roon AH, "Random comparison of repeated faecal immunochemical testing at different intervals for population-based colorectal cancer screening", Gut, 62, pp.409~415 (2013)[DOI]
- "National Health Insurance Service Ilsan Hospital Research Report"[URL]