ArticleTherapeutic advances in gastroenterology2021
Colorectal cancer screening programme: is the French faecal immunological test (FIT) threshold optimal?
Article in Therapeutic advances in gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 4 citations in OpenAlex.
- Potential Impact of Updated Bayesian Deduction in Medicine: Application to Colonoscopy Prioritization.Cancers · 2025Article
- A Pilot Colorectal Cancer Study Using Fecal Occult Blood Tests and Colonoscopy to Identify the Weaknesses of the Romanian Public Healthcare System before Implementing National Screening.International journal of environmental research and public health · 2023Article
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Authors and funding
6 authors at 3 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundIn France, the colorectal cancer organised screening programme uses the faecal immunological test. A positive test ⩾30 μg Hb/g of stool leads to a colonoscopy for identification of potential colorectal lesions. Cut-off values vary from 20 to 47 μg Hb/g of stool in Western countries. We herein question this threshold's relevance in a French population and perform a retrospective observational study using the Parisian database between 1 April 2015 and 31 December 2018.
methodsRates of participation, numbers of positive faecal immunological test (FIT), detection rates and positive predictive values for advanced adenomas and/or colorectal cancer were determined. Mean positivity values for colorectal lesions were calculated.
resultsIn our population, there were 4.1% positive tests and 67.6% colonoscopy results available with final reports. Positive predictive value for advanced adenomas and colorectal cancer were 30% [95% confidence interval (CI) 29.8-30.3] and 7.4% (95% CI 7.35-7.52), respectively. The mean positivity value for all positive tests in our population was 101.7 µg Hb/g of stool (95% CI 85-118.3). There were 1136 normal colonoscopies (21.4%) with a mean positivity value of 88.6 μg Hb/g of stool. Following a negative test in a first screening campaign, 40.8% of patients in our population performed a second test with a positivity rate of 1.3% and with the encounter of 81 colorectal cancers. The risk of having a positive test during the second screening campaign and finding advanced colorectal lesions significantly increased (all
conclusionUsing the current positivity threshold, some patients were considered negative with a delay in colorectal cancer diagnosis, suggesting the threshold could be lowered. Also, the mean positivity value for normal colonoscopies was high, raising the question of upper gastrointestinal bleeding.
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