Abstract：Objective To compare the effectiveness of qualitative and quantitative fecal immunochemical tests (FIT) in identifying colorectal cancer, so as to provide insights into perfecting screening strategies for colorectal cancer. Methods Participants in the Colorectal Cancer Screening Program for Key Populations in Zhejiang Province from May 2020 to December 2021 were recruited, and their demographic information, lifestyle and disease history were collected through a questionnaire survey. Qualitative or quantitative FIT along with a questionnaire-based risk assessment were employed as the initial screening tests. Individuals who were positive in any FIT or had high-risk assessment results were required to attend a subsequent colonoscopy examination. The positive rate, detection rate of colorectal cancer, positive predictive value and number of colonoscopies required were compared between qualitative and quantitative FITs, and stratified analyses by gender and age were conducted. Results Totally 4 099 769 participants were included. The qualitative FIT group included 3 574 917 individuals, yielding a positive rate of 11.35%, a detection rate of 1.19%, a positive predictive value of 0.48% and 83.84 colonoscopies required to detect one cancer case. The quantitative FIT group involved 524 852 individuals, yielding a positive rate of 6.70%, a detection rate of 2.31%, a positive predictive value of 1.01% and 43.23 colonoscopies required to detect one cancer case. The quantitative FIT group showed significantly higher detection rate of colorectal cancer, higher positive predictive value and less number of colonoscopies required compared to the qualitative FIT group (all P<0.05). The same results were obtained after stratification by gender and age. Conclusion Compared to qualitative FIT, quantitative FIT improves the detection of colorectal cancer and reduces the workload of colonoscopy examinations, making it more suitable for colorectal cancer screening in large-scale populations.
和金金, 朱陈, 潘婷婷, 黄文雯, 蒋秉洁, 余炜燕, 王乐, 吴维妙, 杭栋, 杜灵彬. 定性和定量粪便免疫化学试验筛查结直肠癌效果评价[J]. 预防医学, 2024, 36(4): 317-321.
HE Jinjin, ZHU Chen, PAN Tingting, HUANG Wenwen, JIANG Bingjie, YU Weiyan, WANG Le, WU Weimiao, HANG Dong, DU Lingbin. Evaluation of the effectiveness of qualitative and quantitative fecal immunochemical tests in colorectal cancer screening. Preventive Medicine, 2024, 36(4): 317-321.
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