Prospective cross-sectional study on faecal immunochemical tests: sex specific cut-off values to obtain equal sensitivity for colorectal cancer?

BMC Gastroenterology

Veerle MH Coupé²  Leo GM van Rossum⁴  Chris JJ Mulder⁶  Gerrit A Meijer³  Anneke A Bouman⁵  Pieter Scholten⁷  Jochim S Terhaar sive Droste⁶  Arjen P Visscher¹  René WM van der Hulst¹  Frank A Oort⁶  Sietze T van Turenhout⁶ 

[1] Gastroenterology and Hepatology, Kennemer Gasthuis, Haarlem, the Netherlands;Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands;Pathology, VU University Medical Centre, Amsterdam, the Netherlands;Department for health evidence, Radboud University Medical Centre, Nijmegen, the Netherlands;Clinical Chemistry, VU University Medical Centre, Amsterdam, the Netherlands;Department of Gastroenterology and Hepatology, VU University Medical Centre, Amsterdam, the Netherlands;Gastroenterology and Hepatology, Sint Lucas Andreas Hospital, Amsterdam, the Netherlands

关键词: Sex;    Fecal immunochemical test;    Advanced adenoma;    Colorectal cancer screening;   

Others  :  1121725
DOI  :  10.1186/s12876-014-0217-7

 received in 2014-05-05, accepted in 2014-12-11,  发布年份 2014

【 摘 要 】

Background

Faecal immunochemical tests (FITs) are commonly used in colorectal cancer (CRC) screening. Diagnostic accuracy of FIT differs between males and females. This so far unexplained difference could result in a dissimilarity in screening outcome between both sexes. The aim of this study is to compare sensitivity and specificity of a FIT between males and females, and study potential explanatory variables.

Methods

In this cross-sectional study, data were prospectively collected. 3,022 subjects performed a FIT prior to complete colonoscopy. Sensitivity, specificity, and ROC curves were compared for both sexes. Potential explanatory variables of the relation between sensitivity and sex were explored.

Results

At all cut-off values, FIT sensitivity for CRC was higher (range 13-23%) and specificity was lower (range 2-4%) in males compared to females. At 75 ng/ml, sensitivity for CRC was 93% in males compared to 71% in females (p = 0.03), and specificity was 90% in males compared to 93% in females (p = <0.05). For advanced adenomas, males had a slightly higher sensitivity and lower specificity (not significant). At 75 ng/ml, sensitivity for advanced adenomas was 33% in males compared to 29% in females (p = 0.46), and specificity was 93% in males compared to 95% in females (p = 0.22). ROC curves were similar for both sexes, and equal combinations of sensitivity and specificity could be achieved by adjusting the cut-off values. For CRC, the difference in sensitivity could not be explained by age or location of the tumour.

Conclusions

FIT has a higher sensitivity and a lower specificity for CRC in males than in females. Equal test characteristics can be achieved by allowing separate cut-off values for both sexes. Location and age do not explain the observed differences in sensitivity.

【 授权许可】

   
2014 van Turenhout et al.; licensee BioMed Central.

【 图 表 】

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