TY - JOUR
T1 - Diagnostic yield of a risk model versus faecal immunochemical test only
T2 - a randomised controlled trial in a colorectal cancer screening programme
AU - Kortlever, Tim L.
AU - van der Vlugt, Manon
AU - Duijkers, Floor A. M.
AU - Masclee, Ad
AU - Kraaijenhagen, Roderik
AU - Spaander, Manon C. W.
AU - Lansdorp-Vogelaar, Iris
AU - Bossuyt, Patrick M.
AU - Dekker, Evelien
PY - 2023/7/1
Y1 - 2023/7/1
N2 - BackgroundCombining the faecal immunochemical test (FIT) result with risk factors for advanced neoplasia (AN) may increase the yield of colorectal cancer (CRC) screening without increasing the number of colonoscopies. We conducted a randomised controlled trial in the Dutch CRC screening programme to evaluate a previously developed risk model including FIT, age, sex, smoking status, and CRC family history.MethodsA total of 22,748 individuals aged 56-75 years were pre-randomised to the risk-model group or the FIT-only group. Both groups received the FIT; those allocated to the risk-model group also received a single-page questionnaire. Study participants with a positive result (FIT & GE; 15 & mu;g Hb/g faeces and/or risk & GE;0.10) were referred for colonoscopy. The primary outcome measure was the proportion of invitees in whom AN was detected.ResultsIn the risk-model group, 3113/11,364 invitees (27%) returned the FIT and questionnaire versus 3061/11,384 invitees (27%) in the FIT-only group (p = 0.40). The yield of AN was 3.70/1000 invitees in the risk-model group versus 3.43/1000 in the FIT-only group (absolute difference: 0.27/1000, 95%CI: -1.30 to 1.82, p = 0.82).ConclusionsCombining FIT with risk factors for CRC did not increase the yield of AN compared to FIT-only in an existing CRC screening programme. There was no difference in participation between groups.
AB - BackgroundCombining the faecal immunochemical test (FIT) result with risk factors for advanced neoplasia (AN) may increase the yield of colorectal cancer (CRC) screening without increasing the number of colonoscopies. We conducted a randomised controlled trial in the Dutch CRC screening programme to evaluate a previously developed risk model including FIT, age, sex, smoking status, and CRC family history.MethodsA total of 22,748 individuals aged 56-75 years were pre-randomised to the risk-model group or the FIT-only group. Both groups received the FIT; those allocated to the risk-model group also received a single-page questionnaire. Study participants with a positive result (FIT & GE; 15 & mu;g Hb/g faeces and/or risk & GE;0.10) were referred for colonoscopy. The primary outcome measure was the proportion of invitees in whom AN was detected.ResultsIn the risk-model group, 3113/11,364 invitees (27%) returned the FIT and questionnaire versus 3061/11,384 invitees (27%) in the FIT-only group (p = 0.40). The yield of AN was 3.70/1000 invitees in the risk-model group versus 3.43/1000 in the FIT-only group (absolute difference: 0.27/1000, 95%CI: -1.30 to 1.82, p = 0.82).ConclusionsCombining FIT with risk factors for CRC did not increase the yield of AN compared to FIT-only in an existing CRC screening programme. There was no difference in participation between groups.
KW - COLONOSCOPY
KW - NEOPLASIA
KW - FIT
U2 - 10.1038/s41416-023-02358-z
DO - 10.1038/s41416-023-02358-z
M3 - Article
C2 - 37468570
SN - 0007-0920
VL - 129
SP - 791
EP - 796
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 5
ER -