Evidence map›Paper›PMID 30835026›Full record

ArticleDigestive diseases and sciences2019

Low Sensitivity of Fecal Immunochemical Tests and Blood-Based Markers of DNA Hypermethylation for Detection of Sessile Serrated Adenomas/Polyps.

Charles Cock, Shahzaib Anwar, Susan E Byrne, Rosie Meng, Susanne Pedersen, Robert J L Fraser, Graeme P Young, Erin L Symonds

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Article in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Charles CockDepartment of Gastroenterology and Hepatology, Flinders Medical Centre and College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
Shahzaib AnwarDepartment of Gastroenterology and Hepatology, Flinders Medical Centre and College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
Susan E ByrneFlinders Centre for Innovation in Cancer (FCIC), College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
Rosie MengFlinders Centre for Epidemiology and Biostatistics, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
Susanne PedersenClinical Genomics Pty Ltd, North Ryde, NSW, Australia.
Robert J L FraserDepartment of Gastroenterology and Hepatology, Flinders Medical Centre and College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
Graeme P YoungFlinders Centre for Innovation in Cancer (FCIC), College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia.
Erin L SymondsFlinders Centre for Innovation in Cancer (FCIC), College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia. Erin.Symonds@sa.gov.au.ORCID 0000-0003-2451-0358

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly detection and removal of precursor lesions reduce colorectal cancer morbidity and mortality. Sessile serrated adenomas/polyps (SSP) are a recognized precursor of cancer, but there are limited studies on whether current screening techniques detect this pathology.

aimsTo investigate the sensitivity of fecal immunochemical tests (FIT) and epigenetic biomarkers in blood for detection of SSP.

methodsA prospective study offered FIT and a blood test (Colvera for methylated BCAT1 and IKZF1) to adults referred for colonoscopy. Sensitivity of FIT and the blood test were determined for four types of pathology: low-risk conventional adenoma, high-risk adenoma, SSP, and absence of neoplasia. Comparisons were made for FIT positivity at 10 and 20 μg hemoglobin (Hb)/g feces.

resultsOne thousand eight hundred and eighty-two subjects completed FIT and underwent colonoscopy. One thousand four hundred and three were also tested for methylated BCAT1/IKZF1. The sensitivity of FIT (20 μg Hb/g feces) for SSP was 16.3%. This was lower than the sensitivity for high-risk adenomas (28.7%, p < 0.05), but no different to that for low-risk adenomas (13.1%) or no neoplasia (8.4%). A positive FIT result for SSP was not associated with demographics, morphology, concurrent pathology or intake of medications that increase bleeding risk. FIT sensitivity for SSP did not significantly increase through lowering the positivity threshold to 10 μg Hb/g feces (20.4%, p > 0.05). Sensitivity of the blood test for SSP was 8.8%, and 26.5% when combined with FIT.

conclusionsBoth FIT and blood-based markers of DNA hypermethylation have low sensitivity for detection of SSP. Further development of sensitive screening tests is warranted.

Indexed as

DNA MethylationOccult BloodAdenomaAdultAgedAged, 80 and overBiomarkers, TumorColonic NeoplasmsColonic PolypsEarly Detection of CancerFemaleHemoglobinsHumansIkaros Transcription FactorImmunochemistryMaleBCAT1 protein, humanBiomarkers, TumorHemoglobinsIkaros Transcription FactorIKZF1 protein, humanTransaminasesBCAT1BiomarkersColorectal neoplasmsIKZF1Occult bloodScreening

Identifiers

PMID30835026

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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.