Performance of Faecal Immunochemical Testing for Colorectal Cancer Screening at Varying Positivity Thresholds

• DOI: 10.1111/apt.18314
• Publication Date: 2024-10-07T10:44:45Z
• Authors: Kristin Ranheim R...; Edoardo Botteri; Thomas de Lange; Anna Lisa Schult; Sigrun Losada Esk...; Badboni El‐Safadi; Espen R. Norvard; Nils Bolstad; Michael Bretthauer; Geir Hoff; Øyvind Holme
• Keywords: Colorectal cancer screening

ABSTRACT Background The positivity thresholds of faecal immunochemical testing (FIT) in colorectal cancer (CRC) screening vary between countries. Aims To explore the trade‐off colonoscopies performed, adverse events and lesions detected at different FIT a Norwegian CRC trial. Methods We included first participation biennial for 47,265 individuals aged 50–74 years. Individuals with > 15 μg Hb/g faeces were referred colonoscopy. estimated number colonoscopies, events, screen‐detected CRCs, advanced adenomas serrated expected currently or recently used other European countries ranging 20 150 μg/g. Results At μg/g threshold (Norway), 3705 participants underwent colonoscopy, whom 203 had CRC, 1119 256 lesions. Using 47 threshold, 1826 (49.3%) would have undergone 154 (75.9%) been diagnosed 702 (62.7%) adenoma 128 (50.0%) lesion compared to threshold. μg/g, corresponding figures 838 (22.6%) undergoing 114 (56.2%) 345 (30.8%) 54 (21.1%) detection rate stage I was 0.22% 0.11% Post‐colonoscopy bleeding rates 0.8% 1.7%, respectively. Conclusions Increasing reduces colonoscopy demand, but substantially decreases unfavourably changes distribution. risk increased requiring country‐specific information on events. Trial Registration Clinicaltrials.gov identifier: NCT01538550