Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex.

In the fecal immunological test, a suitable cut-off value may be selected to classify results as either positive or negative. Our aim is to estimate the optimal cut-off value for detecting colorectal cancer in different age and sex groups. This is a multicentric retrospective cohort study of partici...

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Autores principales:	Mercedes Vanaclocha-Espi, Josefa Ibáñez, Ana Molina-Barceló, María José Valverde-Roig, Andreu Nolasco, Francisco Pérez-Riquelme, Mariola de la Vega, Isabel Portillo, Dolores Salas
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/52859f6ec1d64455b662710308217b1f
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spelling	oai:doaj.org-article:52859f6ec1d64455b662710308217b1f2021-12-02T20:06:54ZOptimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex.1932-620310.1371/journal.pone.0254021https://doaj.org/article/52859f6ec1d64455b662710308217b1f2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254021https://doaj.org/toc/1932-6203In the fecal immunological test, a suitable cut-off value may be selected to classify results as either positive or negative. Our aim is to estimate the optimal cut-off value for detecting colorectal cancer in different age and sex groups. This is a multicentric retrospective cohort study of participants in CRC screening programs with FIT between 2006 and 2012. A total of 545,505 participations were analyzed. Cancers diagnosed outside of the program were identified after a negative test result (IC_test) up until 2014. The Wilcoxon test was used to compare fecal hemoglobin levels. ROC curves were used to identify the optimal cut-off value for each age and sex group. Screening program results were estimated for different cut-off values. The results show that the Hb concentration was higher in colorectal cancer (average = 179.6μg/g) vs. false positives (average = 55.2μg/g), in IC_test (average = 3.1μg/g) vs. true negatives (average = 0μg/g), and in men (average = 166.2μg/g) vs. women (average = 140.2μg/g) with colorectal cancer. The optimal cut-off values for women were 18.3μg/g (50-59y) and 14.6μg/g (60-69y), and 16.8μg/g (50-59y) and 19.9μg/g (60-69y) for men. Using different cut-off values for each age and sex group lead to a decrease in the IC_test rate compared to the 20μg/g cut-off value (from 0.40‰ to 0.37‰) and an increase in the false positive rate (from 6.45% to 6.99%). Moreover, test sensitivity improved (90.7%), especially in men and women aged 50-59y (89.4%; 90%) and women aged 60-69y (90.2%). In conclusion, the optimal cut-off value varies for different sex and age groups and the use of an optimal cut-off value for each group improves sensitivity and leads to a small decrease in IC_tests, but also to a larger increase in false positives.Mercedes Vanaclocha-EspiJosefa IbáñezAna Molina-BarcelóMaría José Valverde-RoigAndreu NolascoFrancisco Pérez-RiquelmeMariola de la VegaIsabel PortilloDolores SalasPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mercedes Vanaclocha-Espi Josefa Ibáñez Ana Molina-Barceló María José Valverde-Roig Andreu Nolasco Francisco Pérez-Riquelme Mariola de la Vega Isabel Portillo Dolores Salas Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex.
description	In the fecal immunological test, a suitable cut-off value may be selected to classify results as either positive or negative. Our aim is to estimate the optimal cut-off value for detecting colorectal cancer in different age and sex groups. This is a multicentric retrospective cohort study of participants in CRC screening programs with FIT between 2006 and 2012. A total of 545,505 participations were analyzed. Cancers diagnosed outside of the program were identified after a negative test result (IC_test) up until 2014. The Wilcoxon test was used to compare fecal hemoglobin levels. ROC curves were used to identify the optimal cut-off value for each age and sex group. Screening program results were estimated for different cut-off values. The results show that the Hb concentration was higher in colorectal cancer (average = 179.6μg/g) vs. false positives (average = 55.2μg/g), in IC_test (average = 3.1μg/g) vs. true negatives (average = 0μg/g), and in men (average = 166.2μg/g) vs. women (average = 140.2μg/g) with colorectal cancer. The optimal cut-off values for women were 18.3μg/g (50-59y) and 14.6μg/g (60-69y), and 16.8μg/g (50-59y) and 19.9μg/g (60-69y) for men. Using different cut-off values for each age and sex group lead to a decrease in the IC_test rate compared to the 20μg/g cut-off value (from 0.40‰ to 0.37‰) and an increase in the false positive rate (from 6.45% to 6.99%). Moreover, test sensitivity improved (90.7%), especially in men and women aged 50-59y (89.4%; 90%) and women aged 60-69y (90.2%). In conclusion, the optimal cut-off value varies for different sex and age groups and the use of an optimal cut-off value for each group improves sensitivity and leads to a small decrease in IC_tests, but also to a larger increase in false positives.
format	article
author	Mercedes Vanaclocha-Espi Josefa Ibáñez Ana Molina-Barceló María José Valverde-Roig Andreu Nolasco Francisco Pérez-Riquelme Mariola de la Vega Isabel Portillo Dolores Salas
author_facet	Mercedes Vanaclocha-Espi Josefa Ibáñez Ana Molina-Barceló María José Valverde-Roig Andreu Nolasco Francisco Pérez-Riquelme Mariola de la Vega Isabel Portillo Dolores Salas
author_sort	Mercedes Vanaclocha-Espi
title	Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex.
title_short	Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex.
title_full	Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex.
title_fullStr	Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex.
title_full_unstemmed	Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex.
title_sort	optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/52859f6ec1d64455b662710308217b1f
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Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex.

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