Double sampling of a faecal immunochemical test is not superior to single sampling for detection of colorectal neoplasia: a colonoscopy controlled prospective cohort study

BMC Cancer

Research Article

Edwin van Hengel¹  Anneke A Bouman¹  Veerle MH Coupé²  René WM van der Hulst³  Eric IC Wesdorp⁴  Ilhame Ben Larbi⁵  Shannon L Kanis⁵  Chris JJ Mulder⁵  Frank A Oort⁵  Sietze T van Turenhout⁵  Jochim S Terhaar sive Droste⁵  Gerrit A Meijer⁶ 

[1] Clinical Chemistry, VU University Medical Centre, De Boelelaan 1118, Amsterdam, The Netherlands;Epidemiology and Biostatistics, VU University Medical Centre, De Boelelaan 1118, Amsterdam, The Netherlands;Gastroenterology and Hepatology, Kennemer Gasthuis, Boerhaavelaan 22, Haarlem, The Netherlands;Gastroenterology and Hepatology, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, Amsterdam, The Netherlands;Gastroenterology and Hepatology, VU University Medical Centre, De Boelelaan 1118, Amsterdam, The Netherlands;Pathology, VU University Medical Centre, De Boelelaan 1118, Amsterdam, The Netherlands;

关键词: Receiver Operator Curve;    Faecal Immunochemical Test;    Advanced Adenoma;    Early Stage Cancer;    Double Sampling;   

DOI  :  10.1186/1471-2407-11-434

 received in 2011-05-08, accepted in 2011-10-10,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundA single sampled faecal immunochemical test (FIT) has moderate sensitivity for colorectal cancer and advanced adenomas. Repeated FIT sampling could improve test sensitivity. The aim of the present study is to determine whether any of three different strategies of double FIT sampling has a better combination of sensitivity and specificity than single FIT sampling.MethodsTest performance of single FIT sampling in subjects scheduled for colonoscopy was compared to double FIT sampling intra-individually. Test positivity of double FIT sampling was evaluated in three different ways: 1) "one of two FITs+" when at least one out of two measurements exceeded the cut-off value, 2) "two of two FITs+" when both measurements exceeded the cut-off value, 3) "mean of two FITs+" when the geometric mean of two FITs exceeded the cut-off value. Receiver operator curves were calculated and sensitivity of single and the three strategies of double FIT sampling were compared at a fixed level of specificity.ResultsIn 124 of 1096 subjects, screen relevant neoplasia (SRN) were found (i.e. early stage CRC or advanced adenomas). At any cut-off, "two of two FITs+" resulted in the lowest and "one of two FITs+" in the highest sensitivity for SRN (range 35-44% and 42%-54% respectively). ROC's of double FIT sampling were similar to single FIT sampling. At specificities of 85/90/95%, sensitivity of any double FIT sampling strategy did not differ significantly from single FIT (p-values 0.07-1).ConclusionAt any cut off, "one of two FITs+" is the most sensitive double FIT sampling strategy. However, at a given specificity level, sensitivity of any double FIT sampling strategy for SRN is comparable to single FIT sampling at a different cut-off value. None of the double FIT strategies has a superior combination of sensitivity and specificity over single FIT.

【 授权许可】

CC BY   
© Oort et al; licensee BioMed Central Ltd. 2011