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Application of fecal immunochemical test in colorectal cancer screening:A community-based,cross-sectional study in averagerisk individuals in Hainan

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World Journal of Gastrointestinal Oncology 2024年第8期16卷 3445-3456页

作者： Fan Zeng Da-Ya Zhang Shi-Ju Chen Run-Xiang Chen Chen Chen Shi-Mei Huang Da Li Xiao-Dong Zhang Jia-Jia Chen Cui-Yi Mo Lei Gao Jun-Tao Zeng Jian-Xin Xiong Zhai Chen Fei-Hu Bai Graduate School Hainan Medical UniversityHaikou 571199Hainan ProvinceChina Department of Gastroenterology Qionghai People’s HospitalQionghai 571400Hainan ProvinceChina Department of Gastroenterology Sanya Central HospitalSanya 572022Hainan ProvinceChina Department of Gastroenterology Hainan Second People’s HospitalWuzhishang 572299Hainan ProvinceChina Department of Gastroenterology Dongfang People’s HospitalDongfang 572699Hainan ProvinceChina Department of Gastroenterology The Second Affiliated Hospital of Hainan Medical UniversityHaikou 570216Hainan ProvinceChina The Gastroenterology Clinical Medical Center of Hainan Province Haikou 570216Hainan ProvinceChina

BACKGROUND The incidence of colorectal cancer(CRC)in China is steadily rising,with a high proportion of advanced-stage *** highlights the significance of early detection and prevention measures to enhance survival *** immunochemical testing(FIT)is a globally recommended CRC screening method;however,limited research has been conducted on its application in *** To assess the efficacy and adherence of FIT screening among average-risk individuals in Hainan,while also examining the risk factors associated with positive FIT *** This population-based cross-sectional study implemented FIT screening for CRC in 2000 asymptomatic participants aged 40-75 years from five cities and 21 community health centers in Hainan *** study was conducted from August 2022 to April 2023,employing a stratified sampling method to select *** with positive FIT results subsequently underwent *** predictive values for confirmed CRC and advanced adenoma were calculated,and the relationship between relevant variables and positive FIT results was analyzed usingχ2 tests and multivariate logistic *** A total of 1788 participants completed the FIT screening,with a median age of 57 years(interquartile range:40-75).Among them,503(28.1%)were males,and 1285(71.9%)were females,resulting in an 89.4%compliance rate for FIT *** overall positivity rate of FIT was 4.4%[79 out of 1788;95%confidence interval(CI):3%-5%].The specific positivity rates for Haikou,Sanya,Orient City,Qionghai City,and Wuzhishan City were 9.6%(45 of 468;95%CI:8%-11%),1.3%(6 of 445;95%CI:0.1%-3.1%),2.7%(8 of 293;95%CI:1.2%-4.3%),3.3%(9 of 276;95%CI:1.0%-6.3%),and 4.2%(11 of 406;95%CI:1.2%-7.3%),*** associations were found between age,dietary habits,and positive FIT *** of the 79 participants with positive FIT results,55 underwent colonoscopy,demonstrating an 82.2%compliance *** them,10 had a clean

关键词： fecal immunochemical test Colorectal cancer Adenoma Screening Hainan Province

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Comparative yield and efficiency of strategies based on risk assessment and fecal immunochemical test in colorectal cancer screening:A cross-sectional population-based analysis

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Chinese Journal of Cancer Research 2021年第4期33卷 512-521页

作者： Hongda Chen Le Wang Ming Lu Chen Zhu Yunfeng Zhu Weihua Ma Xinmin Chen Lingbin Du Wanqing Chen Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of Cancer Prevention Institute of Cancer and Basic MedicineChinese Academy of Sciences/Cancer Hospital of University of Chinese Academy of Sciences/Zhejiang Cancer HospitalHangzhou 310005China Haining Hospital of Traditional Chinese Medicine Haining 314499China

Objective:Integration of risk stratification into fecal immunochemical test(FIT)might aid in the suboptimal detection of advanced neoplasms by FIT in colorectal cancer(CRC)screening.A comparative study was conducted to evaluate the participation and diagnostic yield of the parallel combination of questionnaire-based risk assessment(QRA)and FIT,FIT-only and QRA-only strategies in a CRC screening program in ***:The study included 29,626 individuals aged 40-74 years and invited to participate in a CRC screening program in *** were first invited to undertake QRA and one-time FIT(OC-sensor).Participants with positive QRA or FIT were deemed to be high-risk individuals who were recommended for subsequent ***,detection rate,and resource demand for colonoscopy were calculated and ***:Of the 29,626 invitees,20,203 completed the parallel combination,8,592 completed the QRA-only,and11 completed the FIT-only *** the parallel combination,FIT-only,and QRA-only strategies,the overall positivity rates were 10.2%(2,928/28,806),5.4%(1,096/20,214),and 6.8%(1,944/28,795),respectively;the yield of advanced neoplasm per 10,000 invitees were 46.9[95%confidence interval(95%CI):39.8-55.4],36.8(95%CI:30.5-44.4),and 12.2(95%CI:8.8-16.8),respectively;the positive predictive values for detecting advanced neoplasms among participants who completed colonoscopy were 4.7%(95%CI:4.0%-5.6%),9.9%(95%CI:8.3%-11.9%),and 1.9%(95%CI:1.3%-2.6%),respectively;the number of colonoscopies required to detect one advanced neoplasm was 11.4(95%CI:9.8-13.4),5.7(95%CI:4.8-6.7),and 28.4(95%CI:20.7-39.2),***:The parallel combination of QRA and FIT did not show superior efficacy for detecting advanced neoplasm compared with FIT alone in this CRC screening program.

关键词： Colorectal neoplasm screening fecal immunochemical test risk stratification

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Head-to-head comparison of the test performance of selfadministered qualitative vs. laboratory-based quantitative fecal immunochemical tests in detecting colorectal neoplasm

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Chinese Medical Journal 2021年第11期134卷 1335-1344页

作者： Ming Lu Yu-Han Zhang Bin Lu Jie Cai Cheng-Cheng Liu Hong-Da Chen Min Dai Office of Cancer Screening National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of General Surgery Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

Background:fecal immunochemical tests(FITs)are the most widely used non-invasive tests in colorectal cancer(CRC)***,evidence about the direct comparison of the test performance of the self-administered qualitative a laboratory-based quantitative FITs in a CRC screening setting is ***:Based on a CRC screening trial(TARGET-C),we included 3144 pre-colonoscopy fecal samples,including 24 CRCs,230 advanced adenomas,622 non-advanced adenomas,and 2268 participants without significant findings at *** selfadministered qualitative FITs(Pupu tube)with positivity thresholds of 8.0,14.4,or 20.8 mg hemoglobin(Hb)/g preset by the manufacturer and one laboratory-based quantitative FIT(OC-Sensor)with a positivity threshold of 20 mg Hb/g recommended by the manufacturer were tested by trained staff in the central *** diagnostic performance of the FITs for detecting colorectal neoplasms was compared in the different scenarios using the preset and adjusted thresholds(for the quantitative FIT).Results:At the thresholds preset by the manufacturers,apart from the qualitative FIT-3,significantly higher sensitivities for detecting advanced adenoma were observed for the qualitative FIT-1(33.9%[95%CI:28.7–39.4%])and qualitative FIT-2(22.2%[95%CI:17.7–27.2%])compared to the quantitative FIT(11.7%[95%CI:8.4–15.8%]),while at a cost of significantly lower ***,such difference was not observed for detecting *** scenarios of adjusting the positivity thresholds of the quantitative FIT to yield comparable specificity or comparable positivity rate to the three qualitative FITs accordingly,there were no significant differences in terms of sensitivity,specificity,positive/negative predictive values and positive/negative likelihood ratios for detecting CRC or advanced adenoma between the two types of FITs,which was further evidenced in ROC ***:Although the self-administered qualitative and the laboratory-based quantitat

关键词： fecal immunochemical test test performance Colorectal neoplasm Screening

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Early diagnostic strategies for colorectal cancer

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World Journal of Gastroenterology 2024年第33期30卷 3818-3822页

作者： Shi-Cai Liu Han Zhang School of Medical Information Wannan Medical CollegeWuhu 241002Anhui ProvinceChina School of Basic Medical Sciences Wannan Medical CollegeWuhu 241002Anhui ProvinceChina

At present,cancer is still an important factor threatening human *** cancer(CRC)is one of the top three most common cancers worldwide and one of the deadliest malignancies in *** latest data showed that CRC incidence and mortality rank third and second,respectively,among global *** and accurate diagnosis is crucial to reduce the morbidity,mortality and improve survival of patients with CRC,but the current early diagnostic methods have *** effectiveness and compliance of diagnostic methods have a certain impact on whether people choose *** this editorial,we explore strategies for the early diagnosis of CRC,including stool-based,blood-based,direct visualization,and imaging examinations.

关键词： Colorectal cancer Diagnostic markers Colonoscopy fecal immunochemical test fecal occult blood test Circulating tumor cells Circulating tumor DNA

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Colon cancer screening:What to choose?

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World Journal of Gastrointestinal Oncology 2024年第8期16卷 3393-3396页

作者： Martin Alonso Gomez Zuleta Department of Internal Medicine Head of Gastroenterology UnitUniversidad Nacional de ColombiaHospital Universitario Nacional de ColombiBogota 571Colombia

Colorectal cancer is one of the predominant tumors in the world,primarily generated by a progression from polyp to cancer which can last several years,giving a great opportunity to the scientific community for its prevention by screening programs that can be done with invasive and non-invasive *** this issue,Lopes et al show us an excellent review of screening,its options,its advantages and disadvantages.

关键词： Colon cancer Adenoma Screening fecal immunochemical test Colonoscopy

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Screening for colorectal cancer in Tianhe,Guangzhou:results of combining fecal immunochemical tests and risk factors for selecting patients requiring colonoscopy

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Gastroenterology Report 2018年第2期6卷 132-136,I0003页

作者： Yi Liao Senmao Li Chunyu Chen Xuan He Feng Lin Jianping Wang Zuli Yang Ping Lan Department of Gastrointestinal Surgery Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdong 510655China Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdong 510655China Department of Colorectal Surgery Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdong 510655China

Objective:To explore the performance of a protocol combining fecal immunochemical test(FIT)and a high-risk factor questionnaire(HRFQ)for selecting patients requiring colonoscopy as part of a population-based colorectal cancer(CRC)screening program in ***:From 2015 to 2016,we conducted a CRC screening program for all residents aged 45 years or older in Tianhe District,Guangzhou City,*** underwent an FIT and received an HRFQ as part of primary *** with positive FIT and/or HRFQ results were considered to be at high risk and were recommended to undergo ***:A total of 10074 subjects were recruited and enrolled in the screening *** the enrolled population,17.5%had positive FIT results and 19.4%had positive HRFQ *** those recommended to undergo diagnostic colonoscopy,773 did *** screening method’s overall positive predictive value(PPV)was 4.9%for non-adenomatous polyps,11.4%for low-risk adenomas(LRAs),15.9%for high-risk adenomas(HRAs)and 1.6%for *** PPVs of positive FIT results for nonadenomatous polyps,LRAs,HRAs and CRC were 5.2%,15.9%,22.5%and 2.5%,*** PPVs of positive HRFQ results for non-adenomatous polyps,LRA,HRA and CRC were 4.1%,10.2%,14.3%and 1.4%,*** PPVs associated with combined positive FIT and HRFQ results for non-adenomatous polyps,LRAs,HRAs and CRC were 4.5%,16.4%,23.7%and 2.8%,***:Our results suggest that this two-step CRC screening strategy,involving a combination of FIT and HRFQ followed by colonoscopy,is useful to identify early-stage *** high detection rates and PPVs for CRC and adenomas encourage this strategy’s use in ongoing screening programs.

关键词： colorectal cancer screening fecal immunochemical test high-risk factors colonoscopy positive predictive value

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Clinical importance of colonoscopy in patients with gastric neoplasm undergoing endoscopic submucosal dissection

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World Journal of Gastroenterology 2017年第23期23卷 4262-4269页

作者： Chieko Tsuchida Naoto Yoshitake Hitoshi Kino Yoshihito Kaneko Masakazu Nakano Kohei Tsuchida Keiichi Tominaga Takako Sasai Hironori Masuyama Hidetsugu Yamagishi Yasuo Imai Hideyuki Hiraishi Department of Gastroenterology Dokkyo Medical University Department of Diagnostic Pathology Dokkyo Medical University

To evaluate the usefulness of total colonoscopy (TCS) for patients undergoing gastric endoscopic submucosal dissection (ESD) and to assess risk factors for colorectal *** the 263 patients who underwent ESD at our department between May 2010 and December 2013, 172 patients undergoing TCS during a one-year period before and after ESD were targeted. After excluding patients with a history of surgery or endoscopic therapy for colorectal neoplasms, 158 patients were analyzed. Of the 868 asymptomatic patients who underwent TCS during the same period because of positive fecal immunochemical test (FIT) results, 158 patients with no history of either surgery or endoscopic therapy for colorectal neoplasms who were matched for age and sex served as the control group for *** revealed adenoma less than 10 mm in 53 patients (33.6%), advanced adenoma in 17 (10.8%), early colorectal cancer in 5 (3.2%), and advanced colorectal cancer in 4 (2.5%). When the presence or absence of adenoma less than 10 mm, advanced adenoma, and colorectal cancer and the number of adenomas were compared between patients undergoing ESD and FIT-positive patients, there were no statistically significant differences in any of the parameters assessed. The patients undergoing ESD appeared to have the same risk of colorectal neoplasms as the FIT-positive patients. Colorectal neoplasms were clearly more common in men than in women (P = 0.031). Advanced adenoma and cancer were significantly more frequent in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus (P = 0.019).CONCLUSIONIn patients undergoing gastric ESD, TCS appears to be important for detecting synchronous double neoplasms. Advanced adenoma and cancer were more common in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus. Caution is therefore especially warranted in patients with these risk factors.

关键词： Colonoscopy Colorectal neoplasm Gastric neoplasm Endoscopic submucosal dissection fecal immunochemical test

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Colorectal cancer population screening programs worldwide in 2016: An update

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World Journal of Gastroenterology 2017年第20期23卷 3632-3642页

作者： Mercedes Navarro Andrea Nicolas Angel Ferrandez Angel Lanas Service of Digestive Diseases University Clinic Hospital Lozano Blesa University of Zaragoza Aragón Health Research Institute (IIS Aragón) CIBERehd

Colorectal cancer(CRC)is the third most commonly diagnosed cancer in the *** incidence and mortality show wide geographical *** is recommended to reduce both incidence and ***,there are significant differences among studies in implementation strategies and *** review aimed to present the results and strategies of different screening programs *** reviewed the literature on national and international screening programs published in Pub Med,on web pages,and in clinical *** Screening programs are currently underway in most European countries,Canada,specific regions in North and South America,Asia,and *** most extensive screening strategies were based on fecal occult blood testing,and more recently,the fecal immunochemical test(FIT).Participation in screening has varied greatly among different *** Netherlands showed the highest participation rate(68.2%)and some areas of Canada showed the lowest(16%).Participation rates were highest among women and in programs that used the FIT *** exhibited the greatest number of positive *** FIT test has been the most widely used screening program *** advent of this test has increased participation rates and the detection of positive results.

关键词： Colorectal cancer Colorectal cancer screening fecal occult blood test fecal immunochemical test Colonoscopy

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Novel multiplex stool-based assay for the detection of early-stage colon cancer in a Chinese population

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World Journal of Gastroenterology 2022年第24期28卷 2705-2720页

作者： Hui-Hong Jiang Si-Wei Xing Xuan Tang Ying Chen Kang Lin Lu-Wei He Mou-Bin Lin Er-Jiang Tang Department of General Surgery Yangpu HospitalTongji UniversityShanghai 200090China Institute of Gastrointestinal Surgery and Translational Medicine Tongji University School of MedicineShanghai 200090China Department of Urology Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai 200025China Center for Clinical Research and Translational Medicine Yangpu HospitalTongji UniversityShanghai 200090China

BACKGROUND Stool DNA(sDNA)methylation analysis is a promising,noninvasive approach for colorectal cancer screening;however,reliable biomarkers for detecting early-stage colon cancer(ECC)are lacking,particularly in the Chinese *** To identify a novel stool-based assay that can improve the effectiveness of ECC *** A blinded case-control study was performed using archived stool samples from 125 ECC patients,and 125 control subjects with normal *** cohort was randomly divided into training and test sets at a 1.5:1 *** bisulfite sequencing(TBSeq)was conducted on five pairs of preoperative and postoperative sDNA samples from ECC patients to identify DNA methylation biomarkers,which were validated using *** logistic regression analysis,a multiplex stool-based assay was developed in the training set,and the detection performance was further assessed in the test set and combined ***χ^(2)test was used to investigate the association of detection sensitivity with clinico-pathological *** Following TBSeq,three hypermethylated cytosine-guanine sites were selected as biomarkers,including paired box 8,Ras-association domain family 1 and secreted frizzled-related protein 2,which differed between the groups and were involved in important cancer *** sDNA panel containing the three biomarkers was constructed with a logistic *** operating characteristic(ROC)analysis revealed that this panel was superior to the fecal immunochemical test(FIT)or serum carcinoembryonic antigen for the detection of *** further found that the combination of the sDNA panel with FIT could improve the screening *** the combined set,the sensitivity,specificity and area under the ROC curve for this multiplex assay were 80.0%,93.6%and 0.918,respectively,and the performance remained excellent in the subgroup analysis by tumor *** addition,the detection sensitivity did not differ with tumor site,tumo

关键词： Colon cancer Early screening Stool biomarker DNA methylation fecal immunochemical test

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Current noninvasive tests for colorectal cancer screening: An overview of colorectal cancer screening tests

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World Journal of Gastrointestinal Oncology 2016年第11期8卷 793-800页

作者： Le-Le Song Yue-Min Li Department of Radiotherapy the Chinese PLA 309 Hospital BioChain(Beijing) Science and Technology Inc.

Colorectal cancer(CRC) has become the third most common cancer in the world. Screening has been shown to be an effective way to identify early CRC and precancerous lesions, and to reduce its morbidity and mortality. Several types of noninvasive tests have been developed for CRC screening, including the fecal occult blood test(FOBT), the fecal immunochemical test(FIT), the fecal-based DNA test and the bloodbased DNA test(the SEPT9 assay). FIT has replaced FOBT and become the major screening test due to high sensitivity, specificity and low costs. The fecal DNA test exhibited higher sensitivity than FIT but its current cost is high for a screening assay. The SEPT9 assay showed good compliance while its performance in screening needs further improvements. These tests exhibited distinct sensitivity and specificity in screening for CRC and adenoma. This article will focus on the performance of the current noninvasive in vitro diagnostic tests that have been used for CRC screening. The merits and drawbacks for these screening methods will also be compared regarding the techniques, usage and costs. We hope this review can provide suggestions for both the public and clinicians in choosing the appropriate method for CRC screening.

关键词： Colorectal cancer Adenoma fecal immunochemical test fecal DNA SEPT9 Septin 9

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