Can a biomarker triage test reduce colonoscopy burden in fecal immunochemical test screening?

Marjolein J. E. Greuter*, Beatriz Carvalho, Meike de Wit, Evelien Dekker, Manon C. W. Spaander, Gerrit A. Meijer, Manon van Engeland, Veerle M. H. Coupe

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Aim: To assess the potential of biomarker triage testing (BM-TT) in the Dutch colorectal cancer (CRC) screening program. Materials & methods: Using the Adenoma and Serrated pathway to Colorectal CAncer model, we simulated fecal immunochemical test (FIT)(47)-screening and various FIT plus BM-TT screening scenarios in which only individuals with both a positive FIT and BM-TT are referred to colonoscopy. Results: Adding a low polyp sensitivity BM-TT to FIT-screening reduced colonoscopy burden (89-100%) while increasing CRC mortality (27-41%) compared with FIT47-screening only. The FIT plus high polyp sensitivity BM-TT scenarios also decreased colonoscopy burden (71-89%) while hardly affecting CRC mortality (FIT47 0-4% increase, FIT15 2-7% decrease). Conclusion: Adding a BM-TT to FIT-screening considerably reduces colonoscopy burden, but could also decrease screening effectiveness. Combining FIT15 with a high polyp sensitivity BM-TT seems most promising.

Original languageEnglish
Pages (from-to)563-571
Number of pages9
JournalJournal of Comparative Effectiveness Research
Volume9
Issue number8
DOIs
Publication statusPublished - Jun 2020

Keywords

  • biomarker test
  • colorectal cancer screening
  • screening burden
  • triage testing
  • COLORECTAL-CANCER
  • COST-EFFECTIVENESS
  • SERRATED PATHWAY
  • CT COLONOGRAPHY
  • IMPACT

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