Diagnostic accuracy of fecal immunochemical test in average- and familial-risk colorectal cancer screening

Joaquín Cubiella; Inés Castro; Vicent Hernandez; Carmen González-Mao; Concepción Rivera; Felipe Iglesias; María Teresa Alves; Lucía Cid; Santiago Soto; Luisa De-Castro; Pablo Vega; Jose Antonio Hermo; Ramiro Macenlle; Alfonso Martínez; Pamela Estevez; Estela Cid; Marta Herreros-Villanueva; Isabel Portillo; Luis Bujanda; Javier Fernández-Seara; COLONPREV study investigators

doi:10.1177/2050640614553285

Diagnostic accuracy of fecal immunochemical test in average- and familial-risk colorectal cancer screening

United European Gastroenterol J. 2014 Dec;2(6):522-9. doi: 10.1177/2050640614553285.

Authors

Joaquín Cubiella¹, Inés Castro¹, Vicent Hernandez², Carmen González-Mao³, Concepción Rivera¹, Felipe Iglesias⁴, María Teresa Alves⁵, Lucía Cid², Santiago Soto¹, Luisa De-Castro², Pablo Vega¹, Jose Antonio Hermo², Ramiro Macenlle¹, Alfonso Martínez², Pamela Estevez², Estela Cid¹, Marta Herreros-Villanueva⁶, Isabel Portillo⁷, Luis Bujanda⁷, Javier Fernández-Seara¹; COLONPREV study investigators

Affiliations

¹ Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
² Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain ; 'IBIV' Institute of Biomedical Research of Vigo, Vigo, Spain.
³ 'IBIV' Institute of Biomedical Research of Vigo, Vigo, Spain ; Department of Clinical Analysis, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
⁴ Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain.
⁵ Research Group: Neurocommunication Advertising and Policy, University of Vigo, Spain.
⁶ Donostia Hospital, Biodonostia Institute, University of the Basque Country UPV/EHU, CIBERehd , San Sebastian, Spain.
⁷ Programa de Cribado de Cáncer Colorrectal, Servicio Vasco de Salud, País Vasco, Spain.

Abstract

Background: There is little information about the fecal immunochemical test (FIT) in familial-risk colorectal cancer (CRC) screening.

Objectives: The objective of this article is to investigate whether FIT diagnostic accuracy for advanced neoplasia (AN) differs between average and familial-risk (first-degree relative) patients.

Methods: A total of 1317 consecutive participants (595 familial) who collected one stool sample before performing a colonoscopy as a CRC screening test were included. FIT diagnostic accuracy for AN was evaluated with Chi-square test at a 20 µg hemoglobin/g of feces cut-off value. Finally, we determined which variables were independently related to AN.

Results: An AN was found in 151 (11.5%) patients. The overall accuracy was not statistically different between both cohorts for AN (88.4%, 91.7%; p = 0.051). At the cut-off stablished, differences in FIT sensitivity (31.1%, 40.6%; p = 0.2) or specificity (96.5%, 97.3%; p = 0.1) were not statistically significant. Finally, independent variables such as sex (male) (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.4-3.1), age (50-65, >65 years) (OR 2.1, 95% CI 1.1-4.3; OR 2.7, 95% CI 1.2-6.1), previous colonoscopy (OR 0.4, 95% CI 0.2-0.9) and FIT ≥20 µg/g feces (OR 17.7, 95% CI 10.8-29.1) were associated with AN diagnosis.

Conclusions: FIT accuracy for AN detection is equivalent in average and familial-risk CRC screening cohorts.

Keywords: Colorectal cancer; colonoscopy; colorectal adenoma; colorectal cancer screening; familial colorectal cancer; fecal immunochemical test; sensitivity and specificity.