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

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 gFO... Mehr ...

Verfasser: Guo, Feng
De Brabander, Isabel
Francart, Julie
Candeur, Michel
Polus, Marc
Van Eycken, Liesbet
Brenner, Hermann
Dokumenttyp: Zeitschriftenartikel
Erscheinungsdatum: 2020
Schlagwörter: Cancer screening / Female [MeSH] / Aged [MeSH] / Colorectal Neoplasms/diagnosis [MeSH] / Humans [MeSH] / Cancer epidemiology / Middle Aged [MeSH] / Health policy / Article / Mass Screening [MeSH] / Early Detection of Cancer [MeSH] / Male [MeSH] / Feces/chemistry [MeSH] / Colorectal Neoplasms/pathology [MeSH] / Guaiac/chemistry [MeSH] / Occult Blood [MeSH]
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27291882
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://repository.publisso.de/resource/frl:6471418

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 µg 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.