TY - JOUR
T1 - Incidence of Interval Colorectal Cancer After Negative Results From First-Round Fecal Immunochemical Screening Tests, by Cutoff Value and Participant Sex and Age
AU - Toes-Zoutendijk, Esther
AU - Kooyker, Arthur I.
AU - Dekker, Evelien
AU - Spaander, Manon C.W.
AU - Opstal-van Winden, Annemieke W.J.
AU - Ramakers, Christian
AU - Buskermolen, Maaike
AU - van Vuuren, Anneke J.
AU - Kuipers, Ernst J.
AU - van Kemenade, Folkert J.
AU - Velthuysen, Marie Louise F.
AU - Thomeer, Maarten G.J.
AU - van Veldhuizen, Harriët
AU - van Ballegooijen, Marjolein
AU - Nagtegaal, Iris D.
AU - de Koning, Harry J.
AU - van Leerdam, Monique E.
AU - Lansdorp-Vogelaar, Iris
AU - van der Beek, A.
AU - Otte, J. A.
AU - Wiersma, Tj
AU - Masclee, A. A.M.
AU - van Bergeijk, J.
AU - Meijer, G.
AU - de Graaf, E. J.R.
AU - van Grevenstein, W. M.U.
AU - Frasa, M.
AU - Jacobs, L. H.J.
AU - Stoker, J.
AU - Vink, G.
AU - Elferink, M. A.
N1 - Funding Information:
Funding This analysis has been carried out as part of the national monitoring and evaluation of the colorectal cancer screening program, funded by the National Institute for Public Health and the Environment ( RIVM ).
Publisher Copyright:
© 2020 AGA Institute
PY - 2020/6
Y1 - 2020/6
N2 - Background & Aims: We evaluated the incidence of interval cancers between the first and second rounds of colorectal cancer (CRC) screening with the FOB-Gold fecal immunochemical test (FIT), and the effects of different cutoff values and patient sex and age. Methods: We collected data from participants in a population-based CRC screening program in the Netherlands who had a negative result from a first-round of FIT screening. We calculated the cumulative incidence of interval cancer after a negative result from a FIT and the sensitivity of the FIT for detection of CRC at a low (15 μg Hb/g feces) and high (47 μg Hb/g feces) cutoff value. Results: Among the 485,112 participants with a negative result from a FIT, 544 interval cancers were detected; 126 were in the 111,800 participants with negative results from a FIT with the low cutoff value and 418 were in the 373,312 FIT participants with negative results from a FIT with the high cutoff value. The mean age of participants tested with the low cutoff value was 72.0 years and the mean age of participants tested the high cutoff value was 66.7 years. The age-adjusted 2-year cumulative incidence of interval cancer after a negative result from a FIT were 9.5 per 10,000 persons at the low cutoff value vs 13.8 per 10,000 persons at the high cutoff value (P < .005). The age-adjusted sensitivity of the FIT for CRC were 90.5% for the low cutoff value vs 82.9% for the high cutoff (P < .0001). The FIT identified men with CRC with 87.4% sensitivity and women with CRC with 82.6% sensitivity (P < .001). Conclusions: In an analysis of data from a FIT population-based screening program in the Netherlands, we found that incidence of interval CRC after a negative result from a FIT to be low. Although the sensitivity of detection of CRC decreased with a higher FIT cutoff value, it remained above 80%.
AB - Background & Aims: We evaluated the incidence of interval cancers between the first and second rounds of colorectal cancer (CRC) screening with the FOB-Gold fecal immunochemical test (FIT), and the effects of different cutoff values and patient sex and age. Methods: We collected data from participants in a population-based CRC screening program in the Netherlands who had a negative result from a first-round of FIT screening. We calculated the cumulative incidence of interval cancer after a negative result from a FIT and the sensitivity of the FIT for detection of CRC at a low (15 μg Hb/g feces) and high (47 μg Hb/g feces) cutoff value. Results: Among the 485,112 participants with a negative result from a FIT, 544 interval cancers were detected; 126 were in the 111,800 participants with negative results from a FIT with the low cutoff value and 418 were in the 373,312 FIT participants with negative results from a FIT with the high cutoff value. The mean age of participants tested with the low cutoff value was 72.0 years and the mean age of participants tested the high cutoff value was 66.7 years. The age-adjusted 2-year cumulative incidence of interval cancer after a negative result from a FIT were 9.5 per 10,000 persons at the low cutoff value vs 13.8 per 10,000 persons at the high cutoff value (P < .005). The age-adjusted sensitivity of the FIT for CRC were 90.5% for the low cutoff value vs 82.9% for the high cutoff (P < .0001). The FIT identified men with CRC with 87.4% sensitivity and women with CRC with 82.6% sensitivity (P < .001). Conclusions: In an analysis of data from a FIT population-based screening program in the Netherlands, we found that incidence of interval CRC after a negative result from a FIT to be low. Although the sensitivity of detection of CRC decreased with a higher FIT cutoff value, it remained above 80%.
KW - Colon Cancer
KW - Fecal Immunochemical Testing
KW - Interval Cancer
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=85085009277&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2019.08.021
DO - 10.1016/j.cgh.2019.08.021
M3 - Article
C2 - 31442598
AN - SCOPUS:85085009277
SN - 1542-3565
VL - 18
SP - 1493
EP - 1500
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 7
ER -