ArticlePloS one2017
Harms, benefits and costs of fecal immunochemical testing versus guaiac fecal occult blood testing for colorectal cancer screening.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- A Systematic Review of Repeat Fecal Occult Blood Tests for Colorectal Cancer Screening.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2020Pooled it
- Pooled it
- Pooled it
- The efficacy of colorectal cancer screening: a systematic review and meta-analysis.Preventive medicine reports · 2026Review
- Photoacoustic-Integrated Multimodal Approach for Colorectal Cancer Diagnosis.ACS biomaterials science & engineering · 2025Review
- Cost effectiveness analysis of three colorectal cancer screening modalities in Kuwait.Scientific reports · 2025Article
- DNA Methylation Biomarker Discovery for Colorectal Cancer Diagnosis Assistance Through Integrated Analysis.Cancer informatics · 2025Article
- Advances in colorectal cancer screening: technological innovations, guideline discrepancies, and individualized strategies.Frontiers in oncology · 2025Review
- "You're dealing with the bottom here…" understanding reasons for reduced utilisation: a qualitative study on colorectal cancer screening among vulnerable men at a drop-in centre in Denmark.BMC public health · 2024Article
- "We're the very bottom, so it's going to be hard for you to 'catch any fish' around here…" understanding vulnerable Greenlanders' perspectives on cancer and barriers to screening in Denmark- A qualitative study.International journal for equity in health · 2024Article
- Cost-effectiveness of Artificial Intelligence-Aided Colonoscopy for Adenoma Detection in Colon Cancer Screening.Journal of the Canadian Association of Gastroenterology · 2023Article
- Review
- Personalized colorectal cancer screening: study protocol of a mixed-methods study on the effectiveness of tailored intervals based on prior f-Hb concentration in a fit-based colorectal cancer screening program (PERFECT-FIT).BMC gastroenterology · 2023Article
- Cost-Effectiveness of Waiving Coinsurance for Follow-Up Colonoscopy after a Positive Stool-Based Colorectal Screening Test in a Medicare Population.Cancer prevention research (Philadelphia, Pa.) · 2022Article
- Cost-Effectiveness of Outreach Strategies for Stool-Based Colorectal Cancer Screening in a Medicaid Population.Population health management · 2022Article
- Mesenchymal Stem/Stromal Cell Therapy Is More Cost-Effective Than Fecal Diversion for Treatment of Perianal Crohn's Disease Fistulas.Frontiers in immunology · 2022Article
- Overall Health Care Cost During the Year Following Diagnosis of Colorectal Cancer Stratified by History of Colorectal Evaluative Procedures.Journal of the Canadian Association of Gastroenterology · 2021Article
- Article
- Canadian Colorectal Cancer Screening Guidelines: Do They Need an Update Given Changing Incidence and Global Practice Patterns?Current oncology (Toronto, Ont.) · 2021Review
- Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundThe ColonCancerCheck screening program for colorectal cancer (CRC) in Ontario, Canada, is considering switching from biennial guaiac fecal occult blood test (gFOBT) screening between age 50-74 years to the more sensitive, but also less specific fecal immunochemical test (FIT). The aim of this study is to estimate whether the additional benefits of FIT screening compared to gFOBT outweigh the additional costs and harms.
methodsWe used microsimulation modeling to estimate quality adjusted life years (QALYs) gained and costs of gFOBT and FIT, compared to no screening, in a cohort of screening participants. We compared strategies with various age ranges, screening intervals, and cut-off levels for FIT. Cost-efficient strategies were determined for various levels of available colonoscopy capacity.
resultsCompared to no screening, biennial gFOBT screening between age 50-74 years provided 20 QALYs at a cost of CAN$200,900 per 1,000 participants, and required 17 colonoscopies per 1,000 participants per year. FIT screening was more effective and less costly. For the same level of colonoscopy requirement, biennial FIT (with a high cut-off level of 200 ng Hb/ml) between age 50-74 years provided 11 extra QALYs gained while saving CAN$333,300 per 1000 participants, compared to gFOBT. Without restrictions in colonoscopy capacity, FIT (with a low cut-off level of 50 ng Hb/ml) every year between age 45-80 years was the most cost-effective strategy providing 27 extra QALYs gained per 1000 participants, while saving CAN$448,300.
interpretationCompared to gFOBT screening, switching to FIT at a high cut-off level could increase the health benefits of a CRC screening program without considerably increasing colonoscopy demand.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.