A Comparison of Single and Combined Schemes of Asia-Pacific Colorectal Screening, Faecal Immunochemical and Stool Deoxyribonucleic Acid Testing for Community Colorectal Cancer Screening

被引：1

作者：

Ze, Yuan ^{[1
]}

Tu, Huiming ^{[2
,9
]}

Zhang, Lin ^{[3
,4
]}

Bai, Yu ^{[5
]}

Ren, Yilin ^{[2
]}

Chen, Xin ^{[1
]}

Xue, Yuzheng ^{[2
]}

Sun, Renjuan ^{[6
]}

Yang, Yuling ^{[7
]}

Yang, Jie ^{[2
]}

Zhou, Xuan ^{[2
]}

Liu, Li ^{[8
]}

机构：

[1] Jiangnan Univ, Wuxi Sch Med, Wuxi, Peoples R China

[2] Jiangnan Univ, Dept Gastroenterol, Affiliated Hosp, Wuxi, Peoples R China

[3] Hefei Comprehens Natl Sci Ctr, Inst Artificial Intelligence, Hefei, Peoples R China

[4] Chinese Acad Med Sci, Peking Union Med Coll, Sch Populat Med & Publ Hlth, Beijing, Peoples R China

[5] Changhai Hosp Shanghai, Dept Gastroenterol, Shanghai, Peoples R China

[6] Jiangnan Univ, Outpatient Nursing Dept, Affiliated Hosp, Wuxi, Peoples R China

[7] Jiangnan Univ, Nursing Dept Geriatr Ward, Affiliated Hosp, Wuxi, Peoples R China

[8] Jiangnan Univ, Data Ctr, Affiliated Hosp, Wuxi, Peoples R China

[9] Jiangnan Univ, Dept Gastroenterol, Affiliated Hosp, 1000 Hefeng Rd, Wuxi 214122, Peoples R China

来源：

JOURNAL OF MULTIDISCIPLINARY HEALTHCARE | 2023年 / 16卷

关键词：

faecal immunochemical testing; stool DNA test; colonoscopy; primary screening; colorectal cancer; OCCULT BLOOD-TESTS; DNA TEST; RISK; COLONOSCOPY;

D O I：

10.2147/JMDH.S398997

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective: To compare the screening efficacy of colonoscopy and pathologically confirmed single and combined Asia-Pacific colorectal screening (APCS), faecal immunochemical testing (FIT) and stool deoxyribonucleic acid (sDNA) testing protocols.Methods: From April 2021 to April 2022, 842 volunteers participated in primary colorectal cancer (CRC) screenings using APCS scoring, FIT and sDNA testing and 115 underwent a colonoscopy. One hundred high-risk participants were then identified from the results of both processes. The differences in the three CRC screening tests in combination with the colonoscopy pathology diagnostics were evaluated using Cochran's Q test, the Dunn-Bonferroni test and area under the receiver operating characteristic curve (AUC) value analysis.Results: Both FIT and sDNA testing demonstrated a 100% performance in detecting CRC. For advanced adenoma, the sensitivity of the FIT + sDNA test scheme (double positive) was 29.2%, and the sensitivities of the combined FIT + sDNA test and APCS scoring + sDNA test schemes were 62.5% and 95.8%, respectively. The FIT + sDNA testing kappa value of advanced colorectal neoplasia was 0.344 (p = 0.011). The sensitivity for nonadvanced adenoma of the APCS score + sDNA test scheme was 91.1%. In terms of positive results, the sensitivity of the APCS score + FIT + sDNA detection protocol was significantly higher than that of the APCS score, FIT, sDNA detection, and FIT + sDNA detection methods (adjustedp < 0.001, respectively). For the FIT + sDNA test, the kappa value was 0.220 (p = 0.015) and the AUC was 0.634 (p = 0.037). The specificity of the FIT + sDNA test scheme was 69.0%. Conclusion: The FIT + sDNA test scheme demonstrated superior diagnostic efficacy, and the combined APCS score + FIT + sDNA test scheme demonstrated remarkable improvements in CRC screening efficiency and sensitivity for detecting positive lesions.

引用

页码：571 / 586

页数：16

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