Gender-specific cut-offs in colorectal cancer screening with FIT: Increased compliance and equal positivity rate
Objective Using quantitative Faecal Immunochemical Test (FIT) in colorectal cancer screening enables adjustment of the cut-off for a positive test. As men have higher stool blood levels and higher prevalence of colorectal neoplasia, different cut-off levels can be chosen for men and women. We evalua...
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| Veröffentlicht in: | Journal of medical screening 2019-06, Vol.26 (2), p.92-97 |
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| creator | Blom, Johannes Löwbeer, Christian Elfström, K. Miriam Sventelius, Marika Öhman, Daniel Saraste, Deborah Törnberg, Sven |
| description | Objective
Using quantitative Faecal Immunochemical Test (FIT) in colorectal cancer screening enables adjustment of the cut-off for a positive test. As men have higher stool blood levels and higher prevalence of colorectal neoplasia, different cut-off levels can be chosen for men and women. We evaluated participation and positivity rates switching from guaiac-based faecal occult blood test (gFOBT) (Hemoccult®) to FIT (OC-Sensor), using gender-specific cut-offs.
Methods
The colorectal cancer screening programme of Stockholm-Gotland, Sweden, started in 2008 and invited individuals aged 60–69 to biennial testing using gFOBT. From 1 October 2015 the test was switched to FIT, with positivity cut-offs of 40 (200) and 80 (400) µg Hb/g (ng/mL) faeces for women and men, respectively. The first year was evaluated for compliance and positivity, number of reminders and incorrect/inadequate tests, compared with gFOBT in the preceding 12-month period.
Results
There were 127,030 and 87,269 individuals invited to screening with gFOBT and FIT, respectively. The change of test increased overall participation by 11.9% (95% confidence interval 11.5%–12.3%) from 56.5% to 68.4% (p |
| doi_str_mv | 10.1177/0969141318804843 |
| format | Article |
| fullrecord | <record><control><sourceid>sage_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_484783</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1177_0969141318804843</sage_id><sourcerecordid>10.1177_0969141318804843</sourcerecordid><originalsourceid>FETCH-LOGICAL-c417t-da9f26688ffe29016e00758ff6cfab1a60275c425e5104c1ecbf7154615ed8a73</originalsourceid><addsrcrecordid>eNp1kEFPwzAMhSMEYmNw54TyBwpx0zYpNzSxMWkSl3GustQZGV1bko5p_55UGxNC4uTYft-T8wi5BXYPIMQDy7McEuAgJUtkws_IEBKRRqnI-TkZ9uuo3w_IlfdrxhgHkJdkwBnnmeBsSNop1iW6yLeorbGa6m0XNcZ4amuqm6pxqDtVUa1qjY567RBrW6_oznbvdDJbPNJZHYbKYxn0m7ayvZKquqT4uQ1k23jb2S_b7alTHV6TC6MqjzfHOiJvk-fF-CWav05n46d5pBMQXVSq3MRZJqUxGOcMMmRMpKHLtFFLUBmLRaqTOMUUWKIB9dIISJMMUiylEnxEooOv32G7XRatsxvl9kWjbHEcfYQXFiE3IXnQs4Neu8Z7h-ZEACv6sIu_YQfk7oAEsw2WJ-An3V83qBUW62br6vDl_w2_AVpRiJM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Gender-specific cut-offs in colorectal cancer screening with FIT: Increased compliance and equal positivity rate</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>SAGE Complete A-Z List</source><creator>Blom, Johannes ; Löwbeer, Christian ; Elfström, K. Miriam ; Sventelius, Marika ; Öhman, Daniel ; Saraste, Deborah ; Törnberg, Sven</creator><creatorcontrib>Blom, Johannes ; Löwbeer, Christian ; Elfström, K. Miriam ; Sventelius, Marika ; Öhman, Daniel ; Saraste, Deborah ; Törnberg, Sven</creatorcontrib><description>Objective
Using quantitative Faecal Immunochemical Test (FIT) in colorectal cancer screening enables adjustment of the cut-off for a positive test. As men have higher stool blood levels and higher prevalence of colorectal neoplasia, different cut-off levels can be chosen for men and women. We evaluated participation and positivity rates switching from guaiac-based faecal occult blood test (gFOBT) (Hemoccult®) to FIT (OC-Sensor), using gender-specific cut-offs.
Methods
The colorectal cancer screening programme of Stockholm-Gotland, Sweden, started in 2008 and invited individuals aged 60–69 to biennial testing using gFOBT. From 1 October 2015 the test was switched to FIT, with positivity cut-offs of 40 (200) and 80 (400) µg Hb/g (ng/mL) faeces for women and men, respectively. The first year was evaluated for compliance and positivity, number of reminders and incorrect/inadequate tests, compared with gFOBT in the preceding 12-month period.
Results
There were 127,030 and 87,269 individuals invited to screening with gFOBT and FIT, respectively. The change of test increased overall participation by 11.9% (95% confidence interval 11.5%–12.3%) from 56.5% to 68.4% (p < 0.001). The increase was larger in men (14.3%) than women (9.7%), and in those aged 60–64 (14.2%) than those aged 65–69 (8.7%). The positivity rate was 2.6% in women and 2.5% in men. There was a lower rate of reminders and incorrect/inadequate tests with FIT.
Conclusions
Within a well-organised colorectal cancer screening programme, changing the test from gFOBT to FIT markedly increased participation, especially among men, and in the younger age group. With a lower cut-off in women than men, the positivity rate was similar.</description><identifier>ISSN: 0969-1413</identifier><identifier>EISSN: 1475-5793</identifier><identifier>DOI: 10.1177/0969141318804843</identifier><identifier>PMID: 30336730</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Aged ; Colonoscopy ; Colorectal Neoplasms - diagnosis ; Early Detection of Cancer - methods ; Early Detection of Cancer - standards ; False Positive Reactions ; Feces ; Female ; Guaiac - therapeutic use ; Humans ; Immunochemistry - methods ; Least-Squares Analysis ; Male ; Mass Screening ; Middle Aged ; Occult Blood ; Reproducibility of Results ; Sex Factors ; Sweden - epidemiology</subject><ispartof>Journal of medical screening, 2019-06, Vol.26 (2), p.92-97</ispartof><rights>The Author(s) 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c417t-da9f26688ffe29016e00758ff6cfab1a60275c425e5104c1ecbf7154615ed8a73</citedby><cites>FETCH-LOGICAL-c417t-da9f26688ffe29016e00758ff6cfab1a60275c425e5104c1ecbf7154615ed8a73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0969141318804843$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0969141318804843$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,777,781,882,21800,27905,27906,43602,43603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30336730$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:140778748$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Blom, Johannes</creatorcontrib><creatorcontrib>Löwbeer, Christian</creatorcontrib><creatorcontrib>Elfström, K. Miriam</creatorcontrib><creatorcontrib>Sventelius, Marika</creatorcontrib><creatorcontrib>Öhman, Daniel</creatorcontrib><creatorcontrib>Saraste, Deborah</creatorcontrib><creatorcontrib>Törnberg, Sven</creatorcontrib><title>Gender-specific cut-offs in colorectal cancer screening with FIT: Increased compliance and equal positivity rate</title><title>Journal of medical screening</title><addtitle>J Med Screen</addtitle><description>Objective
Using quantitative Faecal Immunochemical Test (FIT) in colorectal cancer screening enables adjustment of the cut-off for a positive test. As men have higher stool blood levels and higher prevalence of colorectal neoplasia, different cut-off levels can be chosen for men and women. We evaluated participation and positivity rates switching from guaiac-based faecal occult blood test (gFOBT) (Hemoccult®) to FIT (OC-Sensor), using gender-specific cut-offs.
Methods
The colorectal cancer screening programme of Stockholm-Gotland, Sweden, started in 2008 and invited individuals aged 60–69 to biennial testing using gFOBT. From 1 October 2015 the test was switched to FIT, with positivity cut-offs of 40 (200) and 80 (400) µg Hb/g (ng/mL) faeces for women and men, respectively. The first year was evaluated for compliance and positivity, number of reminders and incorrect/inadequate tests, compared with gFOBT in the preceding 12-month period.
Results
There were 127,030 and 87,269 individuals invited to screening with gFOBT and FIT, respectively. The change of test increased overall participation by 11.9% (95% confidence interval 11.5%–12.3%) from 56.5% to 68.4% (p < 0.001). The increase was larger in men (14.3%) than women (9.7%), and in those aged 60–64 (14.2%) than those aged 65–69 (8.7%). The positivity rate was 2.6% in women and 2.5% in men. There was a lower rate of reminders and incorrect/inadequate tests with FIT.
Conclusions
Within a well-organised colorectal cancer screening programme, changing the test from gFOBT to FIT markedly increased participation, especially among men, and in the younger age group. With a lower cut-off in women than men, the positivity rate was similar.</description><subject>Aged</subject><subject>Colonoscopy</subject><subject>Colorectal Neoplasms - diagnosis</subject><subject>Early Detection of Cancer - methods</subject><subject>Early Detection of Cancer - standards</subject><subject>False Positive Reactions</subject><subject>Feces</subject><subject>Female</subject><subject>Guaiac - therapeutic use</subject><subject>Humans</subject><subject>Immunochemistry - methods</subject><subject>Least-Squares Analysis</subject><subject>Male</subject><subject>Mass Screening</subject><subject>Middle Aged</subject><subject>Occult Blood</subject><subject>Reproducibility of Results</subject><subject>Sex Factors</subject><subject>Sweden - epidemiology</subject><issn>0969-1413</issn><issn>1475-5793</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kEFPwzAMhSMEYmNw54TyBwpx0zYpNzSxMWkSl3GustQZGV1bko5p_55UGxNC4uTYft-T8wi5BXYPIMQDy7McEuAgJUtkws_IEBKRRqnI-TkZ9uuo3w_IlfdrxhgHkJdkwBnnmeBsSNop1iW6yLeorbGa6m0XNcZ4amuqm6pxqDtVUa1qjY567RBrW6_oznbvdDJbPNJZHYbKYxn0m7ayvZKquqT4uQ1k23jb2S_b7alTHV6TC6MqjzfHOiJvk-fF-CWav05n46d5pBMQXVSq3MRZJqUxGOcMMmRMpKHLtFFLUBmLRaqTOMUUWKIB9dIISJMMUiylEnxEooOv32G7XRatsxvl9kWjbHEcfYQXFiE3IXnQs4Neu8Z7h-ZEACv6sIu_YQfk7oAEsw2WJ-An3V83qBUW62br6vDl_w2_AVpRiJM</recordid><startdate>20190601</startdate><enddate>20190601</enddate><creator>Blom, Johannes</creator><creator>Löwbeer, Christian</creator><creator>Elfström, K. Miriam</creator><creator>Sventelius, Marika</creator><creator>Öhman, Daniel</creator><creator>Saraste, Deborah</creator><creator>Törnberg, Sven</creator><general>SAGE Publications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ADTPV</scope><scope>AOWAS</scope></search><sort><creationdate>20190601</creationdate><title>Gender-specific cut-offs in colorectal cancer screening with FIT: Increased compliance and equal positivity rate</title><author>Blom, Johannes ; Löwbeer, Christian ; Elfström, K. Miriam ; Sventelius, Marika ; Öhman, Daniel ; Saraste, Deborah ; Törnberg, Sven</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c417t-da9f26688ffe29016e00758ff6cfab1a60275c425e5104c1ecbf7154615ed8a73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Colonoscopy</topic><topic>Colorectal Neoplasms - diagnosis</topic><topic>Early Detection of Cancer - methods</topic><topic>Early Detection of Cancer - standards</topic><topic>False Positive Reactions</topic><topic>Feces</topic><topic>Female</topic><topic>Guaiac - therapeutic use</topic><topic>Humans</topic><topic>Immunochemistry - methods</topic><topic>Least-Squares Analysis</topic><topic>Male</topic><topic>Mass Screening</topic><topic>Middle Aged</topic><topic>Occult Blood</topic><topic>Reproducibility of Results</topic><topic>Sex Factors</topic><topic>Sweden - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blom, Johannes</creatorcontrib><creatorcontrib>Löwbeer, Christian</creatorcontrib><creatorcontrib>Elfström, K. Miriam</creatorcontrib><creatorcontrib>Sventelius, Marika</creatorcontrib><creatorcontrib>Öhman, Daniel</creatorcontrib><creatorcontrib>Saraste, Deborah</creatorcontrib><creatorcontrib>Törnberg, Sven</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>SwePub</collection><collection>SwePub Articles</collection><jtitle>Journal of medical screening</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blom, Johannes</au><au>Löwbeer, Christian</au><au>Elfström, K. Miriam</au><au>Sventelius, Marika</au><au>Öhman, Daniel</au><au>Saraste, Deborah</au><au>Törnberg, Sven</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gender-specific cut-offs in colorectal cancer screening with FIT: Increased compliance and equal positivity rate</atitle><jtitle>Journal of medical screening</jtitle><addtitle>J Med Screen</addtitle><date>2019-06-01</date><risdate>2019</risdate><volume>26</volume><issue>2</issue><spage>92</spage><epage>97</epage><pages>92-97</pages><issn>0969-1413</issn><eissn>1475-5793</eissn><abstract>Objective
Using quantitative Faecal Immunochemical Test (FIT) in colorectal cancer screening enables adjustment of the cut-off for a positive test. As men have higher stool blood levels and higher prevalence of colorectal neoplasia, different cut-off levels can be chosen for men and women. We evaluated participation and positivity rates switching from guaiac-based faecal occult blood test (gFOBT) (Hemoccult®) to FIT (OC-Sensor), using gender-specific cut-offs.
Methods
The colorectal cancer screening programme of Stockholm-Gotland, Sweden, started in 2008 and invited individuals aged 60–69 to biennial testing using gFOBT. From 1 October 2015 the test was switched to FIT, with positivity cut-offs of 40 (200) and 80 (400) µg Hb/g (ng/mL) faeces for women and men, respectively. The first year was evaluated for compliance and positivity, number of reminders and incorrect/inadequate tests, compared with gFOBT in the preceding 12-month period.
Results
There were 127,030 and 87,269 individuals invited to screening with gFOBT and FIT, respectively. The change of test increased overall participation by 11.9% (95% confidence interval 11.5%–12.3%) from 56.5% to 68.4% (p < 0.001). The increase was larger in men (14.3%) than women (9.7%), and in those aged 60–64 (14.2%) than those aged 65–69 (8.7%). The positivity rate was 2.6% in women and 2.5% in men. There was a lower rate of reminders and incorrect/inadequate tests with FIT.
Conclusions
Within a well-organised colorectal cancer screening programme, changing the test from gFOBT to FIT markedly increased participation, especially among men, and in the younger age group. With a lower cut-off in women than men, the positivity rate was similar.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>30336730</pmid><doi>10.1177/0969141318804843</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SAGE Complete A-Z List |
| subjects | Aged Colonoscopy Colorectal Neoplasms - diagnosis Early Detection of Cancer - methods Early Detection of Cancer - standards False Positive Reactions Feces Female Guaiac - therapeutic use Humans Immunochemistry - methods Least-Squares Analysis Male Mass Screening Middle Aged Occult Blood Reproducibility of Results Sex Factors Sweden - epidemiology |
| title | Gender-specific cut-offs in colorectal cancer screening with FIT: Increased compliance and equal positivity rate |
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