Diagnostic Accuracy of Stool Tests for Colorectal Cancer Surveillance in Hodgkin Lymphoma Survivors

Berbel Ykema; Lisanne Rigter; Manon Spaander; Leon Moons; Tanya Bisseling; Berthe Aleman; Jan Paul de Boer; Pieternella Lugtenburg; Cecile Janus; Eefke Petersen; Judith Roesink; John Raemaekers; Richard van der Maazen; Iris Lansdorp-Vogelaar; Andrea Gini; Wieke Verbeek; Margriet Lemmens; Gerrit Meijer; Flora van Leeuwen; Petur Snaebjornsson; Beatriz Carvalho; Monique van Leerdam

doi:10.3390/jcm9010190

Diagnostic Accuracy of Stool Tests for Colorectal Cancer Surveillance in Hodgkin Lymphoma Survivors

Berbel Ykema
, Lisanne Rigter
, Manon Spaander
, Leon Moons
, Tanya Bisseling
, Berthe Aleman
, Jan Paul de Boer
, Pieternella Lugtenburg
, Cecile Janus
, Eefke Petersen
, Judith Roesink
, John Raemaekers
, Richard van der Maazen
, Iris Lansdorp-Vogelaar
, Andrea Gini
, Wieke Verbeek
, Margriet Lemmens
, Gerrit Meijer
, Flora van Leeuwen
, Petur Snaebjornsson

Beatriz Carvalho, Monique van Leerdam

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

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.

Original language	English
Article number	190
Number of pages	13
Journal	Journal of Clinical medicine
Volume	9
Issue number	1
DOIs	https://doi.org/10.3390/jcm9010190
Publication status	Published - 10 Jan 2020

Keywords

Cancer survivors
Colorectal cancer
Early detection of cancer
Fecal immunochemical testing (FIT)
Hodgkin lymphoma
Multi-target stool test
Sensitivity and specificity

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Ykema, B., Rigter, L., Spaander, M., Moons, L., Bisseling, T., Aleman, B., de Boer, J. P., Lugtenburg, P., Janus, C., Petersen, E., Roesink, J., Raemaekers, J., van der Maazen, R., Lansdorp-Vogelaar, I., Gini, A., Verbeek, W., Lemmens, M., Meijer, G., van Leeuwen, F., ... van Leerdam, M. (2020). Diagnostic Accuracy of Stool Tests for Colorectal Cancer Surveillance in Hodgkin Lymphoma Survivors. Journal of Clinical medicine, 9(1), Article 190. https://doi.org/10.3390/jcm9010190

@article{dabd1e5b3a5c477eb9b0b91e478a809c,

title = "Diagnostic Accuracy of Stool Tests for Colorectal Cancer Surveillance in Hodgkin Lymphoma Survivors",

abstract = "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{\textregistered}) 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.",

keywords = "Cancer survivors, Colorectal cancer, Early detection of cancer, Fecal immunochemical testing (FIT), Hodgkin lymphoma, Multi-target stool test, Sensitivity and specificity",

author = "Berbel Ykema and Lisanne Rigter and Manon Spaander and Leon Moons and Tanya Bisseling and Berthe Aleman and \{de Boer\}, \{Jan Paul\} and Pieternella Lugtenburg and Cecile Janus and Eefke Petersen and Judith Roesink and John Raemaekers and \{van der Maazen\}, Richard and Iris Lansdorp-Vogelaar and Andrea Gini and Wieke Verbeek and Margriet Lemmens and Gerrit Meijer and \{van Leeuwen\}, Flora and Petur Snaebjornsson and Beatriz Carvalho and \{van Leerdam\}, Monique",

note = "Publisher Copyright: {\textcopyright} 2020 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2020",

month = jan,

day = "10",

doi = "10.3390/jcm9010190",

language = "English",

volume = "9",

journal = "Journal of Clinical medicine",

issn = "2077-0383",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

number = "1",

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Ykema, B, Rigter, L, Spaander, M, Moons, L, Bisseling, T, Aleman, B, de Boer, JP, Lugtenburg, P, Janus, C, Petersen, E, Roesink, J, Raemaekers, J, van der Maazen, R, Lansdorp-Vogelaar, I, Gini, A, Verbeek, W, Lemmens, M, Meijer, G, van Leeuwen, F, Snaebjornsson, P, Carvalho, B & van Leerdam, M 2020, 'Diagnostic Accuracy of Stool Tests for Colorectal Cancer Surveillance in Hodgkin Lymphoma Survivors', Journal of Clinical medicine, vol. 9, no. 1, 190. https://doi.org/10.3390/jcm9010190

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

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 - https://www.scopus.com/pages/publications/85114274625

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 -

Diagnostic Accuracy of Stool Tests for Colorectal Cancer Surveillance in Hodgkin Lymphoma Survivors

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