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The optimal cut‐off value in fit‐based colorectal cancer screening: An observational study
BACKGROUND: Colorectal cancer (CRC) screening programs using fecal immunochemical test (FIT) have to choose a cut‐off value to decide which citizens to recall for colonoscopy. The evidence on the optimal cut‐off value is sparse and based on studies with a low number of cancer cases. METHODS: This ob...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940214/ https://www.ncbi.nlm.nih.gov/pubmed/33534955 http://dx.doi.org/10.1002/cam4.3761 |
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author | Njor, Sisse Helle Andersen, Berit Friis‐Hansen, Lennart de Haas, Niels Linnemann, Dorte Nørgaard, Henrik Roikjær, Ole Søndergaard, Bo Rasmussen, Morten |
author_facet | Njor, Sisse Helle Andersen, Berit Friis‐Hansen, Lennart de Haas, Niels Linnemann, Dorte Nørgaard, Henrik Roikjær, Ole Søndergaard, Bo Rasmussen, Morten |
author_sort | Njor, Sisse Helle |
collection | PubMed |
description | BACKGROUND: Colorectal cancer (CRC) screening programs using fecal immunochemical test (FIT) have to choose a cut‐off value to decide which citizens to recall for colonoscopy. The evidence on the optimal cut‐off value is sparse and based on studies with a low number of cancer cases. METHODS: This observational study used data from the Danish Colorectal Cancer Screening Database. Sensitivity and specificity were estimated for various cut‐off values based on a large number of cancers. Traditionally optimal cut‐off values are found by weighting sensitivity and specificity equally. As this might result in too many unnecessary colonoscopies we also provide optimal cut‐off values for different weighting of sensitivity and specificity/number of needed colonoscopies to detect one cancer. RESULTS: Weighting sensitivity and specificity equally gives an optimal cut‐off value of 45 ng Hb/ml. This, however, means making 24 colonoscopies to detect one cancer. Weighting sensitivity lower and for example, aiming at making about 16 colonoscopies to detect one cancer, gives an optimal cut‐off value of 125 ng Hb/ml. CONCLUSIONS: The optimal cut‐off value in an FIT population‐based screening program is 45 ng Hb/ml, when as traditionally sensitivity and specificity are weighted equally. If, however, 24 colonoscopies needed to detect one cancer is too huge a burden on the health care system and the participants, 80, 125, 175, and 350 ng Hb/ml are optimal cut‐off values when only 19/16/14/10 colonoscopies are accepted to find one cancer. |
format | Online Article Text |
id | pubmed-7940214 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-79402142021-03-16 The optimal cut‐off value in fit‐based colorectal cancer screening: An observational study Njor, Sisse Helle Andersen, Berit Friis‐Hansen, Lennart de Haas, Niels Linnemann, Dorte Nørgaard, Henrik Roikjær, Ole Søndergaard, Bo Rasmussen, Morten Cancer Med Cancer Pervention BACKGROUND: Colorectal cancer (CRC) screening programs using fecal immunochemical test (FIT) have to choose a cut‐off value to decide which citizens to recall for colonoscopy. The evidence on the optimal cut‐off value is sparse and based on studies with a low number of cancer cases. METHODS: This observational study used data from the Danish Colorectal Cancer Screening Database. Sensitivity and specificity were estimated for various cut‐off values based on a large number of cancers. Traditionally optimal cut‐off values are found by weighting sensitivity and specificity equally. As this might result in too many unnecessary colonoscopies we also provide optimal cut‐off values for different weighting of sensitivity and specificity/number of needed colonoscopies to detect one cancer. RESULTS: Weighting sensitivity and specificity equally gives an optimal cut‐off value of 45 ng Hb/ml. This, however, means making 24 colonoscopies to detect one cancer. Weighting sensitivity lower and for example, aiming at making about 16 colonoscopies to detect one cancer, gives an optimal cut‐off value of 125 ng Hb/ml. CONCLUSIONS: The optimal cut‐off value in an FIT population‐based screening program is 45 ng Hb/ml, when as traditionally sensitivity and specificity are weighted equally. If, however, 24 colonoscopies needed to detect one cancer is too huge a burden on the health care system and the participants, 80, 125, 175, and 350 ng Hb/ml are optimal cut‐off values when only 19/16/14/10 colonoscopies are accepted to find one cancer. John Wiley and Sons Inc. 2021-02-03 /pmc/articles/PMC7940214/ /pubmed/33534955 http://dx.doi.org/10.1002/cam4.3761 Text en © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Cancer Pervention Njor, Sisse Helle Andersen, Berit Friis‐Hansen, Lennart de Haas, Niels Linnemann, Dorte Nørgaard, Henrik Roikjær, Ole Søndergaard, Bo Rasmussen, Morten The optimal cut‐off value in fit‐based colorectal cancer screening: An observational study |
title | The optimal cut‐off value in fit‐based colorectal cancer screening: An observational study |
title_full | The optimal cut‐off value in fit‐based colorectal cancer screening: An observational study |
title_fullStr | The optimal cut‐off value in fit‐based colorectal cancer screening: An observational study |
title_full_unstemmed | The optimal cut‐off value in fit‐based colorectal cancer screening: An observational study |
title_short | The optimal cut‐off value in fit‐based colorectal cancer screening: An observational study |
title_sort | optimal cut‐off value in fit‐based colorectal cancer screening: an observational study |
topic | Cancer Pervention |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940214/ https://www.ncbi.nlm.nih.gov/pubmed/33534955 http://dx.doi.org/10.1002/cam4.3761 |
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