کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6097408 | 1210289 | 2015 | 12 صفحه PDF | دانلود رایگان |

BackgroundCertain subgroups have higher rates of false fecal immunochemical test (FIT) results, yet few studies have addressed this topic.ObjectiveTo identify demographic factors associated with false-positive and false-negative FIT results in colorectal cancer screening.DesignRetrospective database review of prospectively collected data.SettingA bowel cancer screening center in Hong Kong invited participants for colorectal cancer screening (2008-2012).PatientsStudy participants who underwent both FIT and colonoscopy in the first year (n = 4482) and underwent colonoscopy after negative FIT results for 3 consecutive years (n = 857).Main Outcome MeasurementsThe diagnostic accuracy and predictive values of FIT according to participant characteristics.ResultsThe sensitivity, specificity, positive predictive values, and negative predictive values for advanced neoplasia were 33.1%, 91.9%, 19.0%, and 96.0%, respectively. Participants 66 to 70 years of age had higher sensitivity, whereas older age, smoking, and use of aspirin/nonsteroidal anti-inflammatory drugs were associated with lower specificity. The rates of false-positive and false-negative results were 8.1% and 66.9%, respectively. Older age (66-70 years; adjusted odds ratio [AOR] 1.95; 95% confidence interval [CI], 1.35-2.81; P < .001), smoking (AOR 1.68; 95% CI, 1.08-2.61; P = .020), and the presence of polypoid adenoma (AOR 1.71; 95% CI, 1.14-2.57; P = .009) were associated with false-positive results. Younger participants (AOR for elderly participants 0.31) and the use of aspirin/nonsteroidal anti-inflammatory drugs (AOR 4.44) in participants with 1 FIT with negative results and the absence of high-grade dysplasia (AOR for presence 0.41) were associated with false-negative results.LimitationsSelf-referred participants who received one type of qualitative FIT.ConclusionThese findings could be used to target screening more toward those with a higher risk of false-negative results and those with a lower risk of false-positive results for earlier colonoscopy.
Journal: Gastrointestinal Endoscopy - Volume 81, Issue 3, March 2015, Pages 596-607