Three-year risk of colorectal cancer by faecal haemoglobin concentration in subjects with a negative FIT.

IF 1.7
Donella Puliti, Giuseppe Gorini, Adele Caldarella, Teresa Intrieri, Zhanna Tumanova, Gianfranco Manneschi, Carmen Beatriz Visioli, Beatrice Mallardi, Francesca Battisti, Simonetta Bisanzi, Cristina Sani, Giovanna Masala, Marco Zappa, Paola Mantellini
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Abstract

Introduction and aim: To evaluate whether a risk-stratified colorectal cancer (CRC) screening approach based on a single faecal immunochemical test (FIT) performed better than one using two consecutive tests.

Methods: Approximately 420,000 negative FIT results (positivity cut-off: 20 µg faecal haemoglobin, f-Hb/g) were collected between 2000 and 2015 within the Florence screening program.

Results: The 3-year CRC risk was 15.9‰ in individuals with 15-20 µg/g on a single test, and 9.36‰ for those with a cumulative f-Hb concentration of 20-40 µg/g across two tests.

Discussion: The two-tests approach showed lower discriminatory capacity in identifying the highest-risk subgroup compared to a single test. Screenees with 15-20 µg/g accounted for <1%, but faced a significantly increased 3-year CRC risk.

Conclusion: While increasing screening intensity would require more colonoscopies, extending the screening interval for individuals <60 years with undetectable f-Hb, could allow for the reallocation of colonoscopy resources.

FIT阴性受试者粪便血红蛋白浓度与结直肠癌三年风险的关系
前言和目的:评估基于单次粪便免疫化学试验(FIT)的风险分层结直肠癌(CRC)筛查方法是否优于使用两次连续测试的方法。方法:在2000年至2015年期间,在佛罗伦萨筛查计划中收集了大约42万例FIT阴性结果(阳性临界值:20µg粪便血红蛋白,f-Hb/g)。结果:单次测试中f-Hb浓度为15-20 μ g/g的个体3年结直肠癌风险为15.9‰,两次测试中累积f-Hb浓度为20-40 μ g/g的个体3年结直肠癌风险为9.36‰。讨论:与单一测试相比,双测试方法在识别最高风险亚组方面显示出较低的歧视性能力。结论:虽然增加筛查强度需要更多的结肠镜检查,但延长个体筛查间隔
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