First-Round Fecal Immunochemical Test Concentration Predicts Colorectal Cancer and Advanced Neoplasia in Second-Round Screening.

IF 7.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Masau Sekiguchi, Marcus Westerberg, Christian Löwbeer, Johannes Blom, Anna Forsberg
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引用次数: 0

Abstract

Introduction: Enhancing fecal immunochemical test (FIT)-based colorectal cancer (CRC) screening requires identifying additional predictive factors for colorectal neoplasia beyond current-round FIT concentration. We investigated whether first-round FIT concentration could predict colorectal neoplasia detection in the second screening round, using data from the randomized controlled trial Screening of Swedish Colons (SCREESCO).

Methods: We conducted a cross-sectional analysis of SCREESCO FIT-arm participants with negative two-stool FIT (<10 μg Hb/g feces) in the first screening round, followed by a positive FIT (≥10 μg Hb/g feces) in the second round two years later with work-up colonoscopy. We used binary regression models to assess risk factors for colorectal neoplasia, including CRC and advanced colorectal neoplasia (ACN), at colonoscopy, according to participants' characteristics and first- and second-round FIT concentrations.

Results: In total, 1,991 individuals were included, with median FIT concentrations of 2.2 and 21.8 μg Hb/g feces in the first and second rounds, respectively. Higher first-round FIT concentration was associated with increased risks of CRC and ACN in the second round. Compared to those with first-round FIT concentrations of 0.0-1.9 μg Hb/g feces, the risk ratios for ACN were 1.38 (95% CI: 1.07-1.80) for 2.0-5.9 and 1.85 (95% CI: 1.38-2.48) for 6.0-9.9 μg Hb/g feces. For fixed second-round FIT concentration, the absolute risk of ACN increased in accordance with higher first-round FIT concentration.

Discussion: Even an increase in low levels of FIT concentration is associated with future CRC and ACN detection. Combining first- and second-round FIT results could enhance the efficacy of screening.

Trial registration: ClinicalTrials.gov number, NCT02078804.

第一轮粪便免疫化学试验浓度在第二轮筛查中预测结直肠癌和晚期肿瘤。
导言:加强基于粪便免疫化学试验(FIT)的结直肠癌(CRC)筛查需要确定除当前轮FIT浓度之外的结直肠癌肿瘤的其他预测因素。我们使用随机对照试验筛选瑞典结肠(SCREESCO)的数据,研究了第一轮FIT浓度是否可以预测第二轮筛查中结直肠肿瘤的检测。方法:我们对两便FIT阴性的SCREESCO FIT组参与者进行了横断分析(结果:共纳入1991人,第一轮和第二轮粪便中位FIT浓度分别为2.2和21.8 μg Hb/g。较高的第一轮FIT浓度与第二轮CRC和ACN的风险增加相关。与第一轮FIT浓度为0.0-1.9 μg Hb/g的粪便相比,2.0-5.9 μg粪便ACN的风险比为1.38 (95% CI: 1.07-1.80), 6.0-9.9 μg Hb/g粪便ACN的风险比为1.85 (95% CI: 1.38-2.48)。对于固定的第二轮FIT浓度,ACN的绝对风险随着第一轮FIT浓度的升高而增加。讨论:即使是低水平FIT浓度的增加也与未来的CRC和ACN检测有关。结合第一轮和第二轮FIT结果可以提高筛查的效果。试验注册:ClinicalTrials.gov号码:NCT02078804。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
American Journal of Gastroenterology
American Journal of Gastroenterology 医学-胃肠肝病学
CiteScore
11.40
自引率
5.10%
发文量
458
审稿时长
12 months
期刊介绍: Published on behalf of the American College of Gastroenterology (ACG), The American Journal of Gastroenterology (AJG) stands as the foremost clinical journal in the fields of gastroenterology and hepatology. AJG offers practical and professional support to clinicians addressing the most prevalent gastroenterological disorders in patients.
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