Benefits of switching from guaiac-based faecal occult blood to faecal immunochemical testing: experience from the Wallonia-Brussels colorectal cancer screening programme

被引：16

作者：

Guo, Feng ^{[1
,2
]}

De Brabander, Isabel ^{[3
]}

Francart, Julie ^{[3
]}

Candeur, Michel ^{[4
]}

Polus, Marc ^{[5
]}

Van Eycken, Liesbet ^{[3
]}

Brenner, Hermann ^{[1
,6
,7
,8
]}

机构：

[1] German Canc Res Ctr, Div Clin Epidemiol & Aging Res, Heidelberg, Germany

[2] Heidelberg Univ, Med Fac Heidelberg, Heidelberg, Germany

[3] BCR, Brussels, Belgium

[4] Community Reference Ctr Canc Screening Wallonia, Mont St Guibert, Belgium

[5] Univ Hosp Liege, Dept Gastroenterol, Liege, Belgium

[6] German Canc Res Ctr, Div Prevent Oncol, Heidelberg, Germany

[7] Natl Ctr Tumor Dis NCT, Heidelberg, Germany

[8] German Canc Res Ctr, German Canc Consortium DKTK, Heidelberg, Germany

来源：

BRITISH JOURNAL OF CANCER | 2020年 / 122卷 / 07期

关键词：

INTERVAL CANCERS; COLONOSCOPY CAPACITY; PARTICIPATION RATES; HEMOGLOBIN; PERFORMANCE; MORTALITY; OUTCOMES; ROUNDS; STAGE; RISK;

D O I：

10.1038/s41416-020-0754-5

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background Faecal immunochemical tests (FITs) have replaced guaiac-based faecal occult blood test (gFOBTs) in several colorectal cancer (CRC) screening programmes. We aimed to evaluate the benefits of this transition based on the Wallonia-Brussels-organised CRC screening programme. Methods A total of 1,569,868 individuals aged 50-74 years, who were invited to screening during 2009-2017, were studied by linking their screening records with insurance, pathology and cancer data in the Belgian Cancer Registry. We compared neoplasm detection rates and positive predictive values (PPVs) of gFOBT and FIT at 15 mu g haemoglobin per gram cut-off in screen-naive individuals. We furthermore examined the incidence rates of interval cancer in gFOBT- and FIT-based screening programme. Results Advanced neoplasms were detected less frequently by gFOBT (0.8%) than by FIT (1.3%), with a difference of 0.5% (P < 0.01). PPVs were lower for gFOBT (15.1%) than for FIT (21.7%) for advanced neoplasms (difference 6.6%, P < 0.01). Compared to participants with negative gFOBT, those with negative FIT were 77% less likely to develop interval cancer (incidence rate ratio 0.23, 95% confidence interval 0.16-0.33). Conclusion Our study demonstrated that in an organised CRC screening programme, replacing gFOBT with FIT improved neoplasm detection rate and substantially reduced interval cancer incidence.

引用

页码：1109 / 1117

页数：9

共 43 条

[1] Replacing the Guaiac Fecal Occult Blood Test With the Fecal Immunochemical Test Increases Proportion of Individuals Screened in a Large Healthcare Setting [J].