Cutoff value determines the performance of a semi-quantitative immunochemical faecal occult blood test in a colorectal cancer screening programme.

Content Provider	Europe PMC
Author	van Rossum, L G M van Rijn, A F Laheij, R J F van Oijen, M G H Fockens, P Jansen, J B M J Verbeek, A L M Dekker, E
Copyright Year	2009
Abstract	Background:The cutoff of semi-quantitative immunochemical faecal occult blood tests (iFOBTs) influences colonoscopy referrals and detection rates. We studied the performance of an iFOBT (OC-Sensor) in colorectal cancer (CRC) screening at different cutoffs.Methods:Dutch screening participants, 50–75 years of age, with average CRC risk and an iFOBT value ⩾50 ng ml−1 were offered colonoscopy. The detection rate was the percentage of participants with CRC or advanced adenomas (⩾10 mm, ⩾20% villous, high-grade dysplasia). The number needed to scope (NNTScope) was the number of colonoscopies to be carried out to find one person with CRC or advanced adenomas.Results:iFOBT values ⩾50 ng ml−1 were detected in 526 of 6157 participants (8.5%) and 428 (81%) underwent colonoscopy. The detection rate for advanced lesions (28 CRC and 161 with advanced adenomas) was 3.1% (95% confidence interval: 2.6–3.5%) and the NNTScope was 2.3. At 75 ng ml−1, the detection rate was 2.7%, the NNTScope was 2.0 and the CRC miss rate compared with 50 ng ml−1 was <5% (N=1). At 100 ng ml−1, the detection rate was 2.4% and the NNTScope was <2. Compared with 50 ng ml−1, up to 200 ng ml−1 CRC miss rates remained at 16% (N=4).Conclusions:Cutoffs below the standard 100 ng ml−1 resulted in not only higher detection rates of advanced lesions but also more colonoscopies. With sufficient capacity, 75 ng ml−1 might be advised; if not, up to 200 ng ml−1 CRC miss rates are acceptable compared with the decrease in performed colonoscopies.
ISSN	00070920
Journal	British Journal of Cancer
Volume Number	101
PubMed Central reference number	PMC2768446
Issue Number	8
PubMed reference number	19755997
e-ISSN	15321827
DOI	10.1038/sj.bjc.6605326
Language	English
Publisher	Nature Publishing Group
Publisher Date	2009-09-15
Access Restriction	Open
Rights License	This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material.If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/. Copyright © 2009 Cancer Research UK
Subject Keyword	colorectal cancer faecal occult blood test screening epidemiology colonoscopy
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology