ArticleJournal of medical screening2024
Interval cancer after two rounds of a Swedish population-based screening program using gender-specific cut-off levels in fecal immunochemical test.
Article in Journal of medical screening, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Benefits of colorectal cancer screening using fecal immunochemical testing with varying positivity thresholds by age and sex.Journal of the National Cancer Institute · 2025Pooled it
- Development and external validation of a machine-learning risk model for colorectal cancer triage in Sweden's fast-track pathway.BMC medical informatics and decision making · 2026Article
- Variation in diagnostic performance of fecal immunochemical test (FIT) by cutoffs used in screening programs globally.EClinicalMedicine · 2026Article
- Article
- Levelling up as a fair solution in AI enabled cancer screening.Frontiers in digital health · 2025Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate interval cancer (IC) after two screening rounds of the Swedish population-based screening program of Stockholm-Gotland applying gender-specific cut-off levels in the fecal immunochemical test (FIT).
methodsAll 60- to 69-year-olds invited to screening 2015-2019 were included. The cut-off level for a positive test was 40 µg/g in women and 80 µg/g in men. Screening-detected colorectal cancers (SD CRCs) and ICs were verified in the Swedish Colorectal Cancer Register, and the follow-up time was two years from invitation. The test sensitivity, the IC rate (ICs per 10,000 screening negatives) and the IC incidence (ICs per 100,000 person-years) relative to the background CRC incidence were assessed by gender and age. The FIT levels were compared in men and women for CRCs diagnosed within one year of the sample.
resultsIn the second screening round, 229,187 were invited, and SD CRCs and ICs were diagnosed in 193 and 144, respectively. The IC rate was 8.9 (7.4-10.3) and test sensitivity 0.61 (0.55-0.66), and was similar in men and women. For two screening rounds, the IC rate was significantly higher in men than in women, but the IC incidence/ background CRC incidence was similar in both genders. The FIT levels in female participants with CRC were significantly lower overall, and in early-staged CRCs as compared to men, and proximal localization was more common in women. In multivariable analysis, FIT levels were significantly lower in proximal CRCs.
conclusionOver two rounds, the IC incidence relative to the background CRC incidence was similar in men and women supporting a gender-specific screening strategy. The results could be explained by lower FIT levels in women due to proximal CRC localization.
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