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

BMC Gastroenterology

Research Article

Anneke A Bouman¹  Chris JJ Mulder²  Sietze T van Turenhout²  Frank A Oort²  Jochim S Terhaar sive Droste²  Leo GM van Rossum³  Arjen P Visscher⁴  Veerle MH Coupé⁵  René WM van der Hulst⁶  Pieter Scholten⁷  Gerrit A Meijer⁸ 

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

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

DOI  :  10.1186/s12876-014-0217-7

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

来源: Springer

【 摘 要 】

BackgroundFaecal 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.MethodsIn 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.ResultsAt 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.ConclusionsFIT 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】

CC BY   
© van Turenhout et al.; licensee BioMed Central. 2014