Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex
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Title: | Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex |
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Authors: | Vanaclocha-Espi, Mercedes | Ibáñez, Josefa | Molina-Barceló, Ana | Valverde-Roig, María José | Nolasco, Andreu | Pérez-Riquelme, Francisco | Vega, Mariola de la | Portillo, Isabel | Salas, Dolores |
Center, Department or Service: | Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia |
Keywords: | Colorectal Cancer Screening | Fecal Occult Blood Test | Sensibility |
Knowledge Area: | Enfermería |
Issue Date: | 16-Jul-2021 |
Publisher: | Public Library of Science (PLoS) |
Citation: | Vanaclocha-Espi M, Ibáñez J, Molina-Barceló A, Valverde-Roig MJ, Nolasco A, Pérez-Riquelme F, et al. (2021) Optimal cut-off value for detecting colorectal cancer with fecal immunochemical tests according to age and sex. PLoS ONE 16(7): e0254021. https://doi.org/10.1371/journal.pone.0254021 |
Abstract: | 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. |
Sponsor: | This work was supported by the Instituto de Salud Carlos III, co-founded by the European Regional Development Fund (ERDF) [PI15/02108]. https://www.isciii.es. |
URI: | http://hdl.handle.net/10045/116639 |
ISSN: | 1932-6203 |
DOI: | 10.1371/journal.pone.0254021 |
Language: | eng |
Type: | info:eu-repo/semantics/article |
Rights: | © 2021 Vanaclocha-Espi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
Peer Review: | si |
Publisher version: | https://doi.org/10.1371/journal.pone.0254021 |
Appears in Collections: | INV - SALUD - Artículos de Revistas |
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File | Description | Size | Format | |
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Vanaclocha-Espi_etal_2021_PLoS-ONE.pdf | 919,28 kB | Adobe PDF | Open Preview | |
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