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Interval Cancer Rate and Diagnostic Performance of Fecal Immunochemical Test According to Family History of Colorectal Cancer

Background: The potential role of the fecal immunochemical test (FIT) in individuals with a family history of colorectal cancer (CRC) remains unclear. We assessed interval cancer rate (ICR) after the FIT and FIT diagnostic performance according to family history of CRC. Methods: Using the Korean Nat...

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Autores principales: Jung, Yoon Suk, Lee, Jinhee, Lee, Hye Ah, Moon, Chang Mo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602405/
https://www.ncbi.nlm.nih.gov/pubmed/33066629
http://dx.doi.org/10.3390/jcm9103302
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author Jung, Yoon Suk
Lee, Jinhee
Lee, Hye Ah
Moon, Chang Mo
author_facet Jung, Yoon Suk
Lee, Jinhee
Lee, Hye Ah
Moon, Chang Mo
author_sort Jung, Yoon Suk
collection PubMed
description Background: The potential role of the fecal immunochemical test (FIT) in individuals with a family history of colorectal cancer (CRC) remains unclear. We assessed interval cancer rate (ICR) after the FIT and FIT diagnostic performance according to family history of CRC. Methods: Using the Korean National Cancer Screening Program Database, we collected data on subjects who underwent the FIT between 2009 and 2011. The interval cancer rate (ICR) was defined as the number of subjects diagnosed with CRC within 1 year after the FIT per 1000 subjects with negative FIT results. Results: Of 5,643,438 subjects, 224,178 (3.97%) had a family history of CRC. FIT positivity rate (6.4% vs. 5.9%; adjusted relative risk (aRR) 1.11; 95% confidence interval (CI) 1.09–1.13) and ICR (1.4 vs. 1.1; aRR 1.43 (95% CI 1.27–1.60)) were higher in these subjects than in those with no such history. These results were the same regardless of whether subjects had undergone colonoscopy within the last 5 years before the FIT. However, the diagnostic performance of the FIT for CRC, as measured using the area under the operating characteristic curve, was similar between subjects without a family history and those with one (85.5% and 84.6%, respectively; p = 0.259). Conclusion: the FIT was 1.4 times more likely to miss CRC in subjects with a family history than in those without (aRR 1.43 for ICR), although its diagnostic performance was similar between the two groups. Our results suggest that for individuals with a family history of CRC, colonoscopy should be preferred over FIT for both screening and surveillance.
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spelling pubmed-76024052020-11-01 Interval Cancer Rate and Diagnostic Performance of Fecal Immunochemical Test According to Family History of Colorectal Cancer Jung, Yoon Suk Lee, Jinhee Lee, Hye Ah Moon, Chang Mo J Clin Med Article Background: The potential role of the fecal immunochemical test (FIT) in individuals with a family history of colorectal cancer (CRC) remains unclear. We assessed interval cancer rate (ICR) after the FIT and FIT diagnostic performance according to family history of CRC. Methods: Using the Korean National Cancer Screening Program Database, we collected data on subjects who underwent the FIT between 2009 and 2011. The interval cancer rate (ICR) was defined as the number of subjects diagnosed with CRC within 1 year after the FIT per 1000 subjects with negative FIT results. Results: Of 5,643,438 subjects, 224,178 (3.97%) had a family history of CRC. FIT positivity rate (6.4% vs. 5.9%; adjusted relative risk (aRR) 1.11; 95% confidence interval (CI) 1.09–1.13) and ICR (1.4 vs. 1.1; aRR 1.43 (95% CI 1.27–1.60)) were higher in these subjects than in those with no such history. These results were the same regardless of whether subjects had undergone colonoscopy within the last 5 years before the FIT. However, the diagnostic performance of the FIT for CRC, as measured using the area under the operating characteristic curve, was similar between subjects without a family history and those with one (85.5% and 84.6%, respectively; p = 0.259). Conclusion: the FIT was 1.4 times more likely to miss CRC in subjects with a family history than in those without (aRR 1.43 for ICR), although its diagnostic performance was similar between the two groups. Our results suggest that for individuals with a family history of CRC, colonoscopy should be preferred over FIT for both screening and surveillance. MDPI 2020-10-14 /pmc/articles/PMC7602405/ /pubmed/33066629 http://dx.doi.org/10.3390/jcm9103302 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jung, Yoon Suk
Lee, Jinhee
Lee, Hye Ah
Moon, Chang Mo
Interval Cancer Rate and Diagnostic Performance of Fecal Immunochemical Test According to Family History of Colorectal Cancer
title Interval Cancer Rate and Diagnostic Performance of Fecal Immunochemical Test According to Family History of Colorectal Cancer
title_full Interval Cancer Rate and Diagnostic Performance of Fecal Immunochemical Test According to Family History of Colorectal Cancer
title_fullStr Interval Cancer Rate and Diagnostic Performance of Fecal Immunochemical Test According to Family History of Colorectal Cancer
title_full_unstemmed Interval Cancer Rate and Diagnostic Performance of Fecal Immunochemical Test According to Family History of Colorectal Cancer
title_short Interval Cancer Rate and Diagnostic Performance of Fecal Immunochemical Test According to Family History of Colorectal Cancer
title_sort interval cancer rate and diagnostic performance of fecal immunochemical test according to family history of colorectal cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602405/
https://www.ncbi.nlm.nih.gov/pubmed/33066629
http://dx.doi.org/10.3390/jcm9103302
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