Yield of Colonoscopy After a Positive Result From a Fecal Immunochemical Test OC-Light

Details

• Alternative Title:
  Clin Gastroenterol Hepatol
• Personal Author:
  Alsayid, Muhammad ; Singh, Maneesh H. ; Issaka, Rachel ; Laleau, Victoria ; Day, Lukejohn ; Lee, Jeffrey ; Allison, James ; Somsouk, Ma
• Description:
  Background & Aims
  
  The fecal immunochemical test (FIT) is widely used in colorectal cancer (CRC) screening. The OC-Light FIT is 1 of 2 FITs recommended for CRC screening by the Preventive Services Task Force guidelines. However, little is known about its ability to detect CRC in large average-risk populations.
  
  Methods
  
  We performed a retrospective cohort study of patients (50–75 years old) in the San Francisco Health Network who were screened for CRC by OC-Light FIT from August 2010 through June 2015. Patients with a positive result were referred for colonoscopy. We used electronic health records to identify participants with positive FIT results, and collected results from subsequent colonoscopies and pathology analyses. The FIT positive rate was calculated by dividing the number of positive FIT results by the total number of FIT tests completed. The primary outcome was the positive rate from OC-Light FIT and yield of neoplasms at colonoscopy. Secondary outcomes were findings from first vs subsequent rounds of testing, and how these varied by sex and race.
  
  Results
  
  We collected result from 35,318 FITs, performed on 20,886 patients; 2930 patients (8.3%) had a positive result, and 1558 patients completed the follow-up colonoscopy. A positive result from the FIT identified patients with CRC with a positive predictive value of 3.0%, and patients with advanced adenoma with a positive predictive value of 20.8%. The FIT positive rate was higher during the first round of testing (9.4%) compared to subsequent rounds (7.4%) (P<.01). The yield of CRC in patients with a positive result from the first round of the FIT was 3.7%, and decreased to 1.8% for subsequent rounds (P=.02).
  
  Conclusion
  
  In a retrospective analysis of patients in a diverse safety-net population who underwent OC-Light FIT for CRC screening, we found that approximately 3% of patients with a positive result from a FIT to have CRC and approximately 21% to have advanced adenoma.
  
  
• Subjects:
  Aged Colonoscopy Colorectal Neoplasms Early Detection Of Cancer Feces Female Humans Immunoassay Male Middle Aged Predictive Value Of Tests Retrospective Studies San Francisco

  More +
• Keywords:
  Abnormal Colon Cancer Early Detection Prevention Stool
• Source:
  Clin Gastroenterol Hepatol. 16(10):1593-1597.e1
• Pubmed ID:
  29660528
• Pubmed Central ID:
  PMC6151285
• Document Type:
  Journal Article
• Funding:
  K07 CA212057/CA/NCI NIH HHSUnited States/ ; T32 DK007007/DK/NIDDK NIH HHSUnited States/ ; U48 DP004998/DP/NCCDPHP CDC HHSUnited States/ ; U48DP004998/ACL/ACL HHSUnited States/
• Volume:
  16
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:76350869350051f24b338639e836e625b76fc7c04a35d16fbe3163d790831452
• Download URL:
  https://stacks.cdc.gov/view/cdc/158018/cdc_158018_DS1.pdf
• File Type:
  [PDF - 311.38 KB ]