TY - JOUR
T1 - Diagnostic Accuracy of Stool Tests for Colorectal Cancer Surveillance in Hodgkin Lymphoma Survivors
AU - Ykema, Berbel
AU - Rigter, Lisanne
AU - Spaander, Manon
AU - Moons, Leon
AU - Bisseling, Tanya
AU - Aleman, Berthe
AU - de Boer, Jan Paul
AU - Lugtenburg, Pieternella
AU - Janus, Cecile
AU - Petersen, Eefke
AU - Roesink, Judith
AU - Raemaekers, John
AU - van der Maazen, Richard
AU - Lansdorp-Vogelaar, Iris
AU - Gini, Andrea
AU - Verbeek, Wieke
AU - Lemmens, Margriet
AU - Meijer, Gerrit
AU - van Leeuwen, Flora
AU - Snaebjornsson, Petur
AU - Carvalho, Beatriz
AU - van Leerdam, Monique
N1 - Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/1/10
Y1 - 2020/1/10
N2 - BACKGROUND: Hodgkin lymphoma (HL) survivors have an increased colorectal cancer (CRC) risk. Diagnostic accuracy of quantitative fecal immunochemical testing (FIT, OC Sensor) and/or a multi-target stool DNA test (mt-sDNA, Cologuard®) for advanced neoplasia (AN) was evaluated.METHODS: 101 HL survivors underwent a surveillance colonoscopy and were asked to perform two stool tests (FIT and mt-sDNA). Advanced adenoma (AA), advanced serrated lesion (ASL), and AN (AA, ASL, CRC) were evaluated. Sensitivity, specificity, and area under the curve (AUC) for AN were calculated for different FIT cut-offs and mt-sDNA with colonoscopy as reference.RESULTS: FIT and mt-sDNA were analyzed in 73 (72%) and 82 (81%) participants, respectively. AN was detected in 19 (26%) and 22 (27%), respectively. AN sensitivities for FIT cut-off of 10 ug Hb/g feces (FIT10) and mt-sDNA were 37% (95% confidence interval (CI): 16-62) and 68% (95% CI: 45-86), with corresponding specificities of 91% (95% CI: 80-97) and 70% (95% CI: 57-86), respectively. AUC for FIT was 0.68 (95% CI: 0.54-0.82) and for mt-sDNA 0.76 (95% CI: 0.63-0.89).CONCLUSIONS: In HL survivors, mt-sDNA showed highest sensitivity but with relatively low specificity for AN. Cost-effectiveness analyses is necessary to determine the optimal surveillance strategy.
AB - BACKGROUND: Hodgkin lymphoma (HL) survivors have an increased colorectal cancer (CRC) risk. Diagnostic accuracy of quantitative fecal immunochemical testing (FIT, OC Sensor) and/or a multi-target stool DNA test (mt-sDNA, Cologuard®) for advanced neoplasia (AN) was evaluated.METHODS: 101 HL survivors underwent a surveillance colonoscopy and were asked to perform two stool tests (FIT and mt-sDNA). Advanced adenoma (AA), advanced serrated lesion (ASL), and AN (AA, ASL, CRC) were evaluated. Sensitivity, specificity, and area under the curve (AUC) for AN were calculated for different FIT cut-offs and mt-sDNA with colonoscopy as reference.RESULTS: FIT and mt-sDNA were analyzed in 73 (72%) and 82 (81%) participants, respectively. AN was detected in 19 (26%) and 22 (27%), respectively. AN sensitivities for FIT cut-off of 10 ug Hb/g feces (FIT10) and mt-sDNA were 37% (95% confidence interval (CI): 16-62) and 68% (95% CI: 45-86), with corresponding specificities of 91% (95% CI: 80-97) and 70% (95% CI: 57-86), respectively. AUC for FIT was 0.68 (95% CI: 0.54-0.82) and for mt-sDNA 0.76 (95% CI: 0.63-0.89).CONCLUSIONS: In HL survivors, mt-sDNA showed highest sensitivity but with relatively low specificity for AN. Cost-effectiveness analyses is necessary to determine the optimal surveillance strategy.
KW - Cancer survivors
KW - Colorectal cancer
KW - Early detection of cancer
KW - Fecal immunochemical testing (FIT)
KW - Hodgkin lymphoma
KW - Multi-target stool test
KW - Sensitivity and specificity
UR - http://www.scopus.com/inward/record.url?scp=85114274625&partnerID=8YFLogxK
U2 - 10.3390/jcm9010190
DO - 10.3390/jcm9010190
M3 - Article
C2 - 31936745
SN - 2077-0383
VL - 9
JO - Journal of Clinical medicine
JF - Journal of Clinical medicine
IS - 1
M1 - 190
ER -