Colorectal cancer in patients with single versus double positive faecal immunochemical test results: A retrospective cohort study from a public tertiary hospital.
<h4>Background</h4>Screening for colorectal cancer (CRC) using the faecal immunochemical test (FIT) is widely advocated. Few studies have compared the rate of detecting colonoscopic pathologies in single compared to double FIT-positive follow-up colonoscopy-compliant individuals in a two...
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| Autores principales: | , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2021
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| Acceso en línea: | https://doaj.org/article/3cb1c762f6b94cf0bc90befa388bc3d0 |
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| Sumario: | <h4>Background</h4>Screening for colorectal cancer (CRC) using the faecal immunochemical test (FIT) is widely advocated. Few studies have compared the rate of detecting colonoscopic pathologies in single compared to double FIT-positive follow-up colonoscopy-compliant individuals in a two-sample national FIT screening program.<h4>Objective</h4>To compare CRC incidence in double FIT-positive versus single FIT-positive individuals using a retrospective cohort of patients from a tertiary hospital in Singapore.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>Data was extracted from one public tertiary hospital in Singapore.<h4>Participants</h4>1,422 FIT-positive individuals from the national FIT screening program who were referred to the hospital from 1st January 2017 to 31st March 2020 for follow-up consultation and diagnostic colonoscopy.<h4>Measurements</h4>The exposure of interest was a positive result on both FIT kits. The main outcome was a follow-up diagnostic colonoscopy finding of CRC. The secondary outcome was a diagnostic colonoscopy finding of a colorectal polyp.<h4>Results</h4>Incidence density of CRC was 1.15 and 13.10 per 100,000 person-months, in the single and double FIT-positive group, respectively. This resulted in an incidence rate ratio of 11.40 (95% CI = 4.34, 35.09). Colorectal polyp detection was significantly higher (p < 0.01) in the double (103 of 173 participants; 59.5%) compared to the single (279 of 671 participants; 41.6%) FIT-positive group.<h4>Limitations</h4>The key limitation of this study was the relatively small cohort derived from a single tertiary hospital, as this had the effect of limiting the number of incident cases, resulting in comparatively imprecise CIs.<h4>Conclusions</h4>Double FIT-positive individuals are significantly more likely to have a colonoscopy finding of incident CRC or premalignant polyp than single FIT-positive individuals. Clinicians and policymakers should consider updating their CRC screening protocols accordingly. |
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