Changes in faecal haemoglobin values over sequential rounds of faecal immunochemical tests (FIT) in a surveillance population.

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY
Gemma Mortell, Kate Wooldrage, Gwen A Murphy, Amanda J Cross
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引用次数: 0

Abstract

Objective: Colorectal cancer (CRC) screening enables resection of polyp precursor lesions, preventing cancer or detecting it earlier. Post-polypectomy, people can remain at increased CRC risk, prompting surveillance colonoscopy. Less invasive faecal immunochemical tests (FIT) could reduce the burden of surveillance colonoscopy. We investigated whether changes in FIT values over multiple rounds were associated with advanced colorectal neoplasia (ACN) detection.

Methods: A cohort of men and women aged 60-72 years deemed intermediate risk by the 2002 UK adenoma surveillance guidelines and scheduled for three yearly colonoscopies were recruited (January 2012-December 2013) within the English Bowel Cancer Screening Programme and offered a quantitative FIT at 1, 2 and 3 years post-baseline colonoscopy for a prospective analysis within a diagnostic accuracy study. Participants positive (≥40 µg haemoglobin/g faeces) at 1 year or 2 years were offered early colonoscopy and excluded, otherwise, colonoscopy was offered at 3 years. Only those who completed three FIT rounds and attended the 3-year colonoscopy were included. Participants were grouped based on changes between FIT rounds, with changes defined as absolute differences ≥4 µg/g, and positivity at round 3.

Results: Among 4412 participants, the largest group (n=2773) was the no change category, which had the lowest ACN detection rate (4.7%, 95% CI: 3.9 to 5.5). The serial increase group with a positive round 3 value (n=46) had the highest ACN detection rate (32.6%, 95% CI: 19.5 to 48.0).

Conclusion: No change in FIT result across multiple rounds was associated with a low ACN detection rate, while a serial increase was associated with higher ACN detection rates. Further research should consider if sequential rounds of FIT could be used for stratifying individual risk.

监测人群连续几轮粪便免疫化学试验(FIT)中粪便血红蛋白值的变化。
目的:结直肠癌(CRC)筛查有助于息肉前体病变的切除,预防或早期发现癌症。息肉切除术后,人们仍然有更高的结直肠癌风险,需要进行结肠镜检查。较少侵入性的粪便免疫化学试验(FIT)可以减轻结肠镜检查的负担。我们研究了在多个回合中FIT值的变化是否与晚期结直肠肿瘤(ACN)检测相关。方法:在英国肠癌筛查计划中(2012年1月- 2013年12月)招募了一组年龄在60-72岁的男性和女性,这些男性和女性被认为是2002年英国腺瘤监测指南中的中度风险,并计划每年进行三次结肠镜检查,并在基线结肠镜检查后1、2和3年提供定量FIT,用于诊断准确性研究中的前瞻性分析。阳性(≥40µg血红蛋白/g粪便)的参与者在1年或2年进行早期结肠镜检查并被排除,否则,在3年进行结肠镜检查。仅包括完成三轮FIT检查并参加3年结肠镜检查的患者。参与者根据FIT轮次之间的变化进行分组,变化定义为绝对差异≥4µg/g,并且在第3轮为阳性。结果:在4412名参与者中,最大的组(n=2773)为无变化组,其ACN检出率最低(4.7%,95% CI: 3.9 ~ 5.5)。第3轮阳性的连续增高组(n=46) ACN检出率最高(32.6%,95% CI: 19.5 ~ 48.0)。结论:多轮FIT结果无变化与ACN检出率低相关,而连续增加与ACN检出率高相关。进一步的研究应该考虑连续几轮FIT是否可以用于个体风险分层。
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来源期刊
BMJ Open Gastroenterology
BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.90
自引率
3.20%
发文量
68
审稿时长
2 weeks
期刊介绍: BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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