ArticleEClinicalMedicine2026
Variation in diagnostic performance of fecal immunochemical test (FIT) by cutoffs used in screening programs globally.
Article in EClinicalMedicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Quantitative fecal immunochemical test (FIT) is widely used for colorectal cancer (CRC) screening, with substantial variation in positivity thresholds across countries. This study examines how these thresholds affect FIT's diagnostic performance for detecting CRC and advanced precancerous lesions (APCL). Methods: We analyzed data from a single round screening of 7398 men and women aged 50-79 years, enrolled between 2008 and 2020 in the German BLITZ study, who provided a stool sample for FIT prior to screening colonoscopy. Using FIT positivity thresholds from 30 countries across five continents, we estimated positivity rates, sensitivities for CRC, APCL, and any advanced neoplasia (AN), as well as specificity for no AN, with colonoscopy as the reference standard. Subgroup analyses were conducted by age and sex. Findings: FIT positivity thresholds across the included countries ranged from 8.5 (Belgium, Flanders) to 120 μg Hb/g feces (England, Wales and Northern Ireland). This wide range went along with very wide ranges of positivity rates and diagnostic performance parameters: positivity rate, 17.6% (95% CI: 16.7-18.5) to 2.6% (95% CI: 2.3-3.0); sensitivity for CRC, 98.1% (95% CI: 90.1-100.0) to 55.6% (41.4-69.1); sensitivity for APCL, 45.5% (95% CI: 41.9-49.0) to 12.2% (95% CI: 10.0-14.7); sensitivity for any AN, 48.9% (95% CI: 45.4-52.4) to 15.0% (95% CI: 12.7-17.7); specificity for no AN, 86.3% (95% CI: 85.5-87.2) to 98.9% (95% CI: 98.7-99.2). Interpretation: The broad range of FIT positivity thresholds across countries goes along with very different diagnostic performance parameters. While this limits comparability of results between countries, our results underscore the potential of FIT as a flexible screening tool that can be adapted to the evolving healthcare system capacities in different countries. Funding: German Research Council, the Federal Ministry of Education and Research, and the German Cancer Aid.
Indexed as
Identifiers
What OpenQuestion holds
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.