Three-year risk of colorectal cancer by faecal haemoglobin concentration in subjects with a negative FIT.
To evaluate whether a risk-stratified colorectal cancer (CRC) screening approach based on a single faecal immunochemical test (FIT) performed better than one using two consecutive tests.
Approximately 420,000 negative FIT results (positivity cut-off: 20 µg faecal haemoglobin, f-Hb/g) were collected between 2000 and 2015 within the Florence screening program.
The 3-year CRC risk was 15.9‰ in individuals with 15-20 µg/g on a single test, and 9.36‰ for those with a cumulative f-Hb concentration of 20-40 µg/g across two tests.
The two-tests approach showed lower discriminatory capacity in identifying the highest-risk subgroup compared to a single test. Screenees with 15-20 µg/g accounted for <1%, but faced a significantly increased 3-year CRC risk.
While increasing screening intensity would require more colonoscopies, extending the screening interval for individuals <60 years with undetectable f-Hb, could allow for the reallocation of colonoscopy resources.
Approximately 420,000 negative FIT results (positivity cut-off: 20 µg faecal haemoglobin, f-Hb/g) were collected between 2000 and 2015 within the Florence screening program.
The 3-year CRC risk was 15.9‰ in individuals with 15-20 µg/g on a single test, and 9.36‰ for those with a cumulative f-Hb concentration of 20-40 µg/g across two tests.
The two-tests approach showed lower discriminatory capacity in identifying the highest-risk subgroup compared to a single test. Screenees with 15-20 µg/g accounted for <1%, but faced a significantly increased 3-year CRC risk.
While increasing screening intensity would require more colonoscopies, extending the screening interval for individuals <60 years with undetectable f-Hb, could allow for the reallocation of colonoscopy resources.
Authors
Puliti Puliti, Gorini Gorini, Caldarella Caldarella, Intrieri Intrieri, Tumanova Tumanova, Manneschi Manneschi, Visioli Visioli, Mallardi Mallardi, Battisti Battisti, Bisanzi Bisanzi, Sani Sani, Masala Masala, Zappa Zappa, Mantellini Mantellini
View on Pubmed