Original ResearchFull Report: Clinical—Alimentary TractA Population-based Comparison of Immunochemical Fecal Occult Blood Tests for Colorectal Cancer Screening
Section snippets
Study Population and Design
Between June 2009 and May 2011, there were 19,797 residents of 2 French counties (Allier and Cher) who fulfilled inclusion criteria for the ongoing biennial organized screening program (aged 50–74 y, no digestive symptoms or personal or first-degree relatives with a history of colorectal cancer or advanced adenoma, no colonoscopy in the past 5 years) who were enrolled in a study comparing Magstream and OC Sensor FITs. Participation in the study was suggested at the time of centralized
Results
Figure 1 presents the study flow chart. Among the 1224 subjects who were positive for at least one of the tests, an analyzable colonoscopy was performed for 1075 subjects (87.8%), with a mean time interval between a positive screening and colonoscopy of 71 days (median, 56 days). No colonoscopy complications were reported. A total of 334 participants were diagnosed with advanced neoplasia at colonoscopy.
In Table 1, 16.5% of participants underwent colorectal cancer screening for the first time.
Discussion
Our results, directly comparing the performances of the 2 FITs in an average-risk population, strongly suggest that the OC Sensor outperforms Magstream for both the detection of invasive cancers alone or advanced neoplasias as a whole; the 2 tests provide a substantial improvement in cancer screening in comparison with Hemoccult II. Strikingly, for the same number of positive results, 1-sample OC Sensor nearly doubled the number of advanced neoplasias detected compared with the 3-sample guaiac
Acknowledgments
The authors are grateful to all subjects who agreed to join the study, to the general practitioners who included the patients, to the endoscopists who performed the colonoscopies, to the members of the 2 regional associations in charge of colorectal cancer screening, ADOC18 and ABIDEC, to the Institut InterRégional pour la Santé laboratory, and to the research team Cancers and Preventions who were involved in the study.
References (27)
- et al.
Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial
Lancet
(2010) - et al.
Random comparison of guaiac and immunochemical fecal occult blood tests for colorectal cancer in a screening population
Gastroenterology
(2008) - et al.
Colorectal cancer screening: why immunochemical faecal occult blood test performs as well with either one or two samples
Dig Liv Disease
(2012) - et al.
Positivity rates and performances of immunochemical faecal occult blood tests at different cut-off levels within a colorectal cancer screening programme
Dig Liver Dis
(2012) - et al.
Comparing fecal immunochemical testing: improved standardization is needed
Gastroenterology
(2012) - et al.
A comparison of the immunochemical fecal occult blood test and total colonoscopy in the asymptomatic population
Gastroenterology
(2005) - et al.
Global cancer statistics, 2002
CA Cancer J Clin
(2005) - et al.
Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (hemoccult): an update
Am J Gastroenterol
(2008) - et al.
Once-only sigmoidoscopy in colorectal cancer screening: follow-up findings of the Italian Randomized Controlled Trial—SCORE
J Natl Cancer Inst
(2011) - et al.
Colorectal-cancer incidence and mortality with screening flexible sigmoidoscopy
N Engl J Med
(2012)
A comparison of fecal occult-blood tests for colorectal-cancer screening
N Engl J Med
Screening for colorectal cancer: randomised trial comparing guaiac-based and immunochemical faecal occult blood testing and flexible sigmoidoscopy
Gut
Performance of immunochemical faecal occult blood test in colorectal cancer screening in average-risk population according to positivity threshold and number of samples
Int J Cancer
Cited by (0)
Conflicts of interest The authors disclose no conflicts.
Funding The study was funded by the French National Institute for Cancer (Institut National du Cancer), and the French National League against Cancer (Ligue Nationale Contre le Cancer); the automat analyzers were provided on loan by Eiken (OC Sensor Diana automat) and Fujirebio (Magstream HT automat) manufacturers. The sponsors and manufacturers had no role in the study design or data analysis.