Bibliographic Details
| Title: |
Prospective cross-sectional study on faecal immunochemical tests: sex specific cut-off values to obtain equal sensitivity for colorectal cancer? |
| Authors: |
van Turenhout, Sietze T.1 s.vanturenhout@vumc.nl, Oort, Frank A.1 f.oort@vumc.nl, van der Hulst, René W. M.2 hulst@kg.nl, Visscher, Arjen P.1,2 ap.visscher@vumc.nl, sive Droste, Jochim S. Terhaar1 js.terhaar@vumc.nl, Scholten, Pieter3 p.scholten@slaz.nl, Bouman, Anneke A.4 a.bouman@vumc.nl, Meijer, Gerrit A.5 ga.meijer@vumc.nl, Mulder, Chris J. J.1 cjmulder@vumc.nl, van Rossum, Leo G. M.1,6 l.g.m.v.rossum@gr.nl, Coupé, Veerle M. H.7 v.coupe@vumc.nl |
| Source: |
BMC Gastroenterology. 2014, Vol. 14 Issue 1, p235-254. 21p. 1 Diagram, 4 Charts, 2 Graphs. |
| Subject Terms: |
*COLON cancer diagnosis, *EARLY detection of cancer, *SEX factors in disease, *IMMUNOCHEMISTRY, *HEALTH outcome assessment, *COLONOSCOPY, *COMPARATIVE studies |
| Abstract: |
Background: Faecal immunochemical tests (FITs) are commonly used in colorectal cancer (CRC) screening. Diagnostic accuracy of FIT differs between males and females. This so far unexplained difference could result in a dissimilarity in screening outcome between both sexes. The aim of this study is to compare sensitivity and specificity of a FIT between males and females, and study potential explanatory variables Methods: In this cross-sectional study, data were prospectively collected. 3,022 subjects performed a FIT prior to complete colonoscopy. Sensitivity, specificity, and ROC curves were compared for both sexes. Potential explanatory variables of the relation between sensitivity and sex were explored. Results: At all cut-off values, FIT sensitivity for CRC was higher (range 13-23%) and specificity was lower (range 2-4%) in males compared to females. At 75 ng/ml, sensitivity for CRC was 93% in males compared to 71% in females (p = 0.03), and specificity was 90% in males compared to 93% in females (p = <0.05). For advanced adenomas, males had a slightly higher sensitivity and lower specificity (not significant). At 75 ng/ml, sensitivity for advanced adenomas was 33% in males compared to 29% in females (p = 0.46), and specificity was 93% in males compared to 95% in females (p = 0.22). ROC curves were similar for both sexes, and equal combinations of sensitivity and specificity could be achieved by adjusting the cut-off values. For CRC, the difference in sensitivity could not be explained by age or location of the tumour. Conclusions: FIT has a higher sensitivity and a lower specificity for CRC in males than in females. Equal test characteristics can be achieved by allowing separate cut-off values for both sexes. Location and age do not explain the observed differences in sensitivity. [ABSTRACT FROM AUTHOR] |
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| Database: |
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