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:	Tian Zhi Lim, Jerrald Lau, Gretel Jianlin Wong, Ker-Kan Tan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3cb1c762f6b94cf0bc90befa388bc3d0
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spelling	oai:doaj.org-article:3cb1c762f6b94cf0bc90befa388bc3d02021-12-02T20:03:57ZColorectal cancer in patients with single versus double positive faecal immunochemical test results: A retrospective cohort study from a public tertiary hospital.1932-620310.1371/journal.pone.0250460https://doaj.org/article/3cb1c762f6b94cf0bc90befa388bc3d02021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0250460https://doaj.org/toc/1932-6203<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.Tian Zhi LimJerrald LauGretel Jianlin WongKer-Kan TanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0250460 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tian Zhi Lim Jerrald Lau Gretel Jianlin Wong Ker-Kan Tan Colorectal cancer in patients with single versus double positive faecal immunochemical test results: A retrospective cohort study from a public tertiary hospital.
description	<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.
format	article
author	Tian Zhi Lim Jerrald Lau Gretel Jianlin Wong Ker-Kan Tan
author_facet	Tian Zhi Lim Jerrald Lau Gretel Jianlin Wong Ker-Kan Tan
author_sort	Tian Zhi Lim
title	Colorectal cancer in patients with single versus double positive faecal immunochemical test results: A retrospective cohort study from a public tertiary hospital.
title_short	Colorectal cancer in patients with single versus double positive faecal immunochemical test results: A retrospective cohort study from a public tertiary hospital.
title_full	Colorectal cancer in patients with single versus double positive faecal immunochemical test results: A retrospective cohort study from a public tertiary hospital.
title_fullStr	Colorectal cancer in patients with single versus double positive faecal immunochemical test results: A retrospective cohort study from a public tertiary hospital.
title_full_unstemmed	Colorectal cancer in patients with single versus double positive faecal immunochemical test results: A retrospective cohort study from a public tertiary hospital.
title_sort	colorectal cancer in patients with single versus double positive faecal immunochemical test results: a retrospective cohort study from a public tertiary hospital.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/3cb1c762f6b94cf0bc90befa388bc3d0
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Colorectal cancer in patients with single versus double positive faecal immunochemical test results: A retrospective cohort study from a public tertiary hospital.

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