Review
Gastroenterology & Hepatology
Noel Pin-Vieito, Manuel Puga, Daniel Fernandez-de-Castro, Joaquin Cubiella
Summary: FIT is widely used as a biomarker for colorectal cancer diagnosis and plays a crucial role in screening and surveillance. This review summarizes the diagnostic efficacy of FIT in symptomatic patients and post-adenoma resection, as well as discusses the potential impact of FIT strategies on healthcare resources and CRC prognosis.
WORLD JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Oncology
Sara G. Ribe, Edoardo Botteri, Magnus Loberg, Kristin R. Randel, Mette Kalager, Jens Aksel Nilsen, Elisabeth H. Gulichsen, Oyvind Holme
Summary: This study investigated the impact of time interval between faecal immunochemical testing (FIT) cycles on the detection rate of colorectal cancer (CRC) and advanced neoplasia (AN). The results showed that although the detection rates of CRC and AN increased with increasing time interval between FITs, individuals who had undetectable faecal haemoglobin (f-Hb) at the first screening round had a substantially lower risk of CRC at the next screening round compared to individuals with detectable f-Hb.
INTERNATIONAL JOURNAL OF CANCER
(2023)
Review
Medical Laboratory Technology
Gavin R. C. Clark, Robert J. C. Steele, Callum G. Fraser
Summary: Women are at a disadvantage in colorectal cancer screening due to lower faecal haemoglobin concentrations, leading to poorer outcomes. Risk scoring strategies that consider sex have not been extensively tested or introduced. Governments and agencies should prioritize allocating resources to implement simple strategies, such as using different haemoglobin thresholds, to achieve equal positivity in both sexes.
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
(2022)
Article
Public, Environmental & Occupational Health
Matthew T. Keys, Miquel Serra-Burriel, Natalia Martinez-Lizaga, Maria Pellise, Francesc Balaguer, Ariadna Sanchez, Enrique Bernal-Delgado, Antoni Castells
Summary: The study found that FIT-based organized colorectal cancer screening in Spain was associated with a reduction in population colorectal cancer mortality. No differences in outcome trends were observed between exposed and control provinces in the 7 years prior to screening implementation. Two years after implementation, exposed provinces experienced an increase in colorectal cancer incidence, followed by a decrease in mortality rates after 7 years.
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
(2021)
Article
Medicine, General & Internal
Lasse Kaalby, Ulrik Deding, Issam Al-Najami, Gabriele Berg-Beckhoff, Thomas Bjorsum-Meyer, Tinne Laurberg, Aasma Shaukat, Robert J. C. Steele, Anastasios Koulaouzidis, Morten Rasmussen, Morten Kobaek-Larsen, Gunnar Baatrup
Summary: New research suggests that faecal haemoglobin concentration (f-Hb) can indicate the presence of serious diseases not related to colorectal cancer (CRC). This study found an association between increasing f-Hb and the risk of mortality, as well as an increased risk of dying from respiratory disease, cardiovascular disease, and other cancers. f-Hb may be a potential biomarker for non-CRC diseases.
Article
Multidisciplinary Sciences
Miriam P. van der Meulen, Esther Toes-Zoutendijk, Manon C. W. Spaander, Evelien Dekker, Johannes M. G. Bonfrer, Anneke J. van Vuuren, Ernst J. Kuipers, Folkert J. van Kemenade, M. F. van Velthuysen, Maarten G. J. Thomeer, Harriet van Veldhuizen, Harry J. de Koning, Iris Lansdorp-Vogelaar, Monique E. van Leerdam
Summary: The participation rate in FIT screening is lower for individuals with a lower socioeconomic status (SES), but they have a higher detection rate for advanced neoplasia. Screening has the potential to reduce health inequalities in CRC mortality.
Review
Medicine, General & Internal
Esmee J. Grobbee, Pieter Ha Wisse, Eline H. Schreuders, Aafke van Roon, Leonie van Dam, Ann G. Zauber, Iris Lansdorp-Vogelaar, Wichor Bramer, Sarah Berhane, Jonathan J. Deeks, Ewout W. Steyerberg, Monique E. van Leerdam, Manon Cw Spaander, Ernst J. Kuipers
Summary: FIT is superior to gFOBT in detecting advanced colorectal neoplasia and colorectal cancer in average-risk individuals. The specificity of both tests was similar, while the sensitivity of FIT was significantly higher than gFOBT at pre-specified specificities.
COCHRANE DATABASE OF SYSTEMATIC REVIEWS
(2022)
Article
Medical Laboratory Technology
Sally C. Benton, Carolyn Piggott, Zahida Zahoor, Shane O'Driscoll, Callum G. Fraser, Nigel D'Souza, Michelle Chen, Theo Georgiou Delisle, Muti Abulafi
Summary: This study assessed the comparability of faecal haemoglobin concentrations obtained with four quantitative FIT systems at different thresholds. The results showed differences between systems at lower thresholds, highlighting the need for further understanding of their clinical impact and efforts to minimize these differences.
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
(2022)
Article
Gastroenterology & Hepatology
Manuel Zorzi, Jessica Battagello, Kevin Selby, Giulia Capodaglio, Susanna Baracco, Silvia Rizzato, Enrico Chinellato, Stefano Guzzinati, Massimo Rugge
Summary: A study conducted in the Veneto region of Italy found that the risk of colorectal cancer mortality is significantly higher among individuals who do not undergo colonoscopy after a positive FIT result, highlighting the importance of increasing compliance in this high-risk population.
Article
Oncology
Edoardo Botteri, Geir Hoff, Kristin R. Randel, Oyvind Holme, Thomas de Lange, Tomm Bernklev, Eline Aas, Mona Berthelsen, Erik Natvig, Benedicte Kirkoen, Markus D. Knudsen, Ane S. Kvaerner, Anna L. Schult, Giske Ursin, Anita Jorgensen, Paula Berstad
Summary: This study assessed the participation rates of different population subgroups in colorectal cancer screening, and found that male gender, young age, low education and income, being retired or unemployed, living alone, being an immigrant, long driving time, and the use of certain drugs were associated with low participation. It was also found that fecal immunochemical testing (FIT) screening had more equal access compared to sigmoidoscopy screening.
INTERNATIONAL JOURNAL OF CANCER
(2022)
Article
Oncology
Anton Gies, Tobias Niedermaier, Elizabeth Alwers, Thomas Hielscher, Korbinian Weigl, Thomas Heisser, Petra Schrotz-King, Michael Hoffmeister, Hermann Brenner
Summary: This study evaluated the performance of nine fecal immunochemical tests in screening colonoscopy participants, with differences in diagnostic performance observed by sex and age. Females consistently showed lower sensitivities and higher specificities than males, with higher negative predictive values. A negative FIT was found to be less reliable in ruling out AN among men and older participants than among women and younger participants.
Article
Gastroenterology & Hepatology
Han-Mo Chiu, Grace Hsiao-Hsuan Jen, Ying-Wei Wang, Jean Ching-Yuan Fann, Chen-Yang Hsu, Ya-Chung Jeng, Amy Ming-Fang Yen, Sherry Yueh-Hsia Chiu, Sam Li-Sheng Chen, Wen-Feng Hsu, Yi-Chia Lee, Ming-Shiang Wu, Chien-Yuan Wu, Yann-Yuh Jou, Tony Hsiu-Hsi Chen
Summary: A large-scale population-based biennial FIT screening showed a significant 34% reduction in advanced-stage CRCs and a 40% reduction in death from CRC, with greater long-term effectiveness in the distal colon. The findings provide strong and consistent evidence-based policy support for sustainable population-based FIT organized service screening worldwide.
Article
Oncology
Andrea Cruz, Carla M. Carvalho, Alexandra Cunha, Anais Crespo, Agueda Iglesias, Laura Garcia-Nimo, Paulo P. Freitas, Joaquin Cubiella
Summary: The study aimed to analyze the diagnostic value of six biomarkers in stool samples of patients with CRC, advanced adenomas, other lesions, and healthy individuals. Results showed that Hb and M2-PK levels were increased in CRC patients compared to controls, suggesting a potential as fecal diagnostic biomarkers for CRC detection.
Article
Medical Laboratory Technology
Caroline J. Chapman, Ayan Banerjea, David J. Humes, Jaren Allen, Simon Oliver, Abby Ford, Katie Hardy, Natasha Djedovic, Richard F. Logan, Joanne R. Morling
Summary: The study found large variations in f-Hb when different FIT devices were used, but smaller variation when the same FIT device was used. This suggests that analyzer-specific f-Hb cut-offs should be applied with regard to clinical decision making, especially at lower f-Hb levels.
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
(2021)
Review
Oncology
Jakub Switalski, Tomasz Tatara, Katarzyna Wnuk, Wojciech Miazga, Dagmara Karauda, Adrian Matera, Magdalena Jablonska, Sylwia Jopek, Urszula Religioni, Mariusz Gujski
Summary: Colorectal cancer is a common neoplasm that greatly impacts quality of life and mortality. The FIT (faecal immunochemical test) is a promising and increasingly used screening method, and this umbrella review confirms its high usefulness in early detection of CRC.
Article
Public, Environmental & Occupational Health
Gavin R. C. Clark, Jayne Digby, Callum G. Fraser, Judith A. Strachan, Robert J. C. Steele
Summary: There is evidence that colorectal cancer screening using faecal haemoglobin is less effective in women than men, with women having lower faecal haemoglobin concentrations compared to men. This gender difference in faecal haemoglobin concentrations persists across different stages and sites of colorectal cancer. To address gender inequalities, screening programs may need to consider using different faecal haemoglobin concentration thresholds for women and men.
JOURNAL OF MEDICAL SCREENING
(2022)
Article
Oncology
Lasse Kaalby, Issam Al-Najami, Ulrik Deding, Gabriele Berg-Beckhoff, Robert J. C. Steele, Morten Kobaek-Larsen, Aasma Shaukat, Morten Rasmussen, Gunnar Baatrup
Summary: This study found that screening participants with detectable fecal hemoglobin had higher mortality rates and different causes of death compared to those without. Fecal hemoglobin may serve as a marker for diseases not directly related to colorectal cancer and may be targeted for preventive measures in the future.
Letter
Public, Environmental & Occupational Health
Bob Steele
JOURNAL OF MEDICAL SCREENING
(2022)
Article
Medical Laboratory Technology
Craig Mowat, Jayne Digby, Shirley Cleary, Lynne Gray, Pooja Datt, David R. Goudie, Robert J. C. Steele, Judith A. Strachan, Adam Humphries, Callum G. Fraser
Summary: Quantitative FIT can serve as a good tumor marker in post-polypectomy surveillance, reducing the need for colonoscopy and minimizing potential risks for patients.
ANNALS OF CLINICAL BIOCHEMISTRY
(2022)
Article
Medicine, General & Internal
Lasse Kaalby, Ulrik Deding, Issam Al-Najami, Gabriele Berg-Beckhoff, Thomas Bjorsum-Meyer, Tinne Laurberg, Aasma Shaukat, Robert J. C. Steele, Anastasios Koulaouzidis, Morten Rasmussen, Morten Kobaek-Larsen, Gunnar Baatrup
Summary: New research suggests that faecal haemoglobin concentration (f-Hb) can indicate the presence of serious diseases not related to colorectal cancer (CRC). This study found an association between increasing f-Hb and the risk of mortality, as well as an increased risk of dying from respiratory disease, cardiovascular disease, and other cancers. f-Hb may be a potential biomarker for non-CRC diseases.
Article
Nutrition & Dietetics
Annie S. Anderson, Claire Donaghy, Ross Lamb, Robert J. C. Steele, Susan Moug
Summary: The BeWEL trial showed that a significant proportion of colorectal adenoma patients are interested in lifestyle interventions and achieved clinically relevant weight loss at 12-month follow-up. However, replicating the program in a non-research setting was found to be less feasible, and alternative approaches should be explored.
JOURNAL OF HUMAN NUTRITION AND DIETETICS
(2023)
Article
Oncology
Ulrik Deding, Lasse Kaalby, Robert Steele, Issam Al-Najami, Morten Kobaek-Larsen, Eva Plantener, Jeppe B. Madsen, Jonna S. Madsen, Thomas Bjorsum-Meyer, Gunnar Baatrup
Summary: Population-based screening for colorectal cancer using FIT is recommended. Detectable faecal haemoglobin can indicate colorectal neoplasia as well as other conditions. A positive FIT predicts an increased risk of death from colorectal cancer but might also predict an increased risk of all-cause mortality.
EUROPEAN JOURNAL OF CANCER
(2023)
Article
Public, Environmental & Occupational Health
Gavin R. C. Clark, Callum G. Fraser, Judith A. Strachan, Robert J. C. Steele
Summary: Colorectal cancer (CRC) screening using faecal tests reduces disease-specific mortality. This study examined mortality rates and its association with sex before and after CRC screening in Scotland. The results showed that CRC mortality declined from 1990 to 2020, but the decline differed between sexes, indicating a larger beneficial effect of screening on CRC mortality in men compared to women.
EUROPEAN JOURNAL OF PUBLIC HEALTH
(2023)
Article
Public, Environmental & Occupational Health
Jayne Digby, Callum G. Fraser, Gavin Clark, Craig Mowat, Judith A. Strachan, Robert J. C. Steele
Summary: This study aimed to develop a risk-scoring model for colorectal cancer using data from the Scottish Bowel Screening Programme. Only faecal haemoglobin concentration and age showed a significant association with colorectal cancer. By tailoring the threshold for faecal haemoglobin concentration according to age, the disparity in interval cancer proportion between women and men could be reduced.
JOURNAL OF MEDICAL SCREENING
(2023)
Article
Gastroenterology & Hepatology
Robert S. Bresalier, Carlo Senore, Graeme P. Young, James Allison, Robert Benamouzig, Sally Benton, Patrick M. M. Bossuyt, Luis Caro, Beatriz Carvalho, Han-Mo Chiu, Veerle M. H. Coupe, Willemijn de Klaver, Clasine Maria de Klerk, Evelien Dekker, Sunil Dolwani, Callum G. Fraser, William Grady, Lydia Guittet, Samir Gupta, Stephen P. Halloran, Ulrike Haug, Geir Hoff, Steven Itzkowitz, Tim Kortlever, Anastasios Koulaouzidis, Uri Ladabaum, Beatrice Lauby-Secretan, Marcis Leja, Bernard Levin, Theodore Robert Levin, Finlay Macrae, Gerrit A. Meijer, Joshua Melson, Colm O'Morain, Susan Parry, Linda Rabeneck, David F. Ransohoff, Roque Saenz, Hiroshi Saito, Silvia Sanduleanu-Dascalescu, Robert E. Schoen, Kevin Selby, Harminder Singh, Robert J. C. Steele, Joseph J. Y. Sung, Erin Leigh Symonds, Sidney J. Winawer
Summary: New non-invasive tests for colorectal cancer (CRC) are emerging, making it challenging to conduct trials with mortality reduction as the main goal. A formal consensus approach involving experts resulted in the revision of previously established principles and the emergence of twelve new principles. The effectiveness of a new test can be evaluated by comparing it with an established non-invasive test, with the faecal immunochemical test considered as the appropriate comparator. Flexible adjustment of the new test's positivity threshold is desirable to meet different screening goals and requirements. A four-phased approach is proposed for the evaluation of new tests, including small studies, prospective estimation of accuracy, evaluation in screening populations, and monitoring for missed lesions.
Article
Public, Environmental & Occupational Health
Gavin R. C. Clark, Thomas Godfrey, Calum Purdie, Judith Strachan, Francis A. Carey, Callum G. Fraser, Robert J. C. Steele
Summary: This study compared the interval cancer proportions between the FIT-based Scottish Bowel Screening Programme and the former gFOBT-based program, and investigated the associations between interval cancer and factors such as faecal haemoglobin concentration, sex, age, deprivation, site, and stage. The results showed that FIT had a higher proportion of screen detected cancers compared to interval cancers, and women had a higher proportion of interval cancers than men. Lowering the faecal haemoglobin threshold could reduce the number of interval cancers, but additional colonoscopy would be required.
JOURNAL OF MEDICAL SCREENING
(2023)
Article
Oncology
Louisa Flander, Evelien Dekker, Berit Andersen, Mette Bach Larsen, Robert J. Steele, Nea Malila, Tytti Sarkeala, Manon van der Vlugt, Clasine de Klerk, Bart Knottnerus, Lucinda Bertels, Anke Woudstra, Manon C. W. Spaander, Mirjam Fransen, Sirpa Heinavaara, Mary Dillon, Driss Ait Ouakrim, Mark Jenkins
Summary: The participation rate of colorectal cancer (CRC) screening in Australia is low. Through comparing national bowel cancer screening programs, we found that countries such as the Netherlands, Scotland, Denmark, and Finland have higher participation rates. These programs share common characteristics such as smaller populations, higher literacy rates, one-sample iFOBT kits, national registration systems, and research on program features.
Article
Medicine, General & Internal
U. Stromberg, C. Bonander, M. Westerberg, L. A. Levin, C. Metcalfe, R. Steele, L. Holmberg, A. Forsberg, R. Hultcrantz
Summary: The study found a significant socioeconomic gradient in colonoscopy attendance proportion. The gradient was more pronounced in the PCOL group compared to the FIT x 2 screening. Despite similar socioeconomic gradients in uptake, there may be a higher risk of exacerbating health inequalities with organized colorectal cancer screening using a PCOL strategy than a FIT strategy.
Article
Medical Informatics
Sian Taylor-Phillips, Farah Seedat, Goda Kijauskaite, John Marshall, Steve Halligan, Chris Hyde, Rosalind Given-Wilson, Louise Wilkinson, Alastair K. Denniston, Ben Glocker, Peter Garrett, Anne Mackie, Robert J. Steele
Summary: Artificial intelligence has the potential to accurately classify mammograms and replace or supplement radiologists in breast cancer screening. Evaluations of AI systems by the UK National Screening Committee focus on maximizing benefits and minimizing harms to women. Additional information on the spectrum of disease detected and interval cancers is crucial for understanding the benefits and harms of screening.
LANCET DIGITAL HEALTH
(2022)
Review
Health Care Sciences & Services
Anna Bobrowska, Molly Murton, Farah Seedat, Cristina Visintin, Anne Mackie, Robert Steele, John Marshall
Summary: This study compared the definitions and components of screening terms and presented an updated definition of targeted screening. Targeted screening and selective screening were found to be conceptually interchangeable, while cascade screening was only applicable to genetic diseases.
LANCET REGIONAL HEALTH-EUROPE
(2022)
